TY - JOUR
T1 - Characteristics and outcome of patients with core-binding factor acute myeloid leukemia and FLT3-ITD
T2 - Results from an international collaborative study
AU - Kayser, Sabine
AU - Kramer, Michael
AU - Martínez-Cuadrón, David
AU - Grenet, Justin
AU - Metzeler, Klaus H.
AU - Sustkova, Zuzana
AU - Luskin, Marlise R.
AU - Brunner, Andrew M.
AU - Elliott, Michelle A.
AU - Gil, Cristina
AU - Marini, Sandra Casal
AU - Ráčil, Zdeněk
AU - Cetkovsky, Petr
AU - Novak, Jan
AU - Perl, Alexander E.
AU - Platzbecker, Uwe
AU - Stölzel, Friedrich
AU - Ho, Anthony D.
AU - Thiede, Christian
AU - Stone, Richard M.
AU - Röllig, Christoph
AU - Montesinos, Pau
AU - Schlenk, Richard F.
AU - Levis, Mark J.
N1 - Publisher Copyright:
© 2022 Ferrata Storti Foundation.
PY - 2022/4
Y1 - 2022/4
N2 - The aim of this study was to evaluate the prognostic impact of FLT3-ITD in core-binding factor acute myeloid leukemia (CBFAML) in an international, multicenter survey of 97 patients of whom 52% had t(8;21)(q22;q22) and 48% had inv(16)(p13q22)/t(16;16)(p13;q22). The median age of the patients was 53 years (range, 19-81). Complete remission after anthracycline-based induction (n=86) and non-intensive therapy (n=11) was achieved in 97% and 36% of the patients, respectively. The median follow-up was 4.43 years (95% confidence interval [95% CI]: 3.35-7.39 years). The median survival after intensive and non-intensive treatment was not reached and 0.96 years, respectively. Among intensively treated patients, inv(16) with trisomy 22 (n=11) was associated with a favorable 4-year relapse-free survival rate of 80% (95% CI: 59-100%) as compared to 38% (95% CI: 27-54%; P=0.02) in all other patients with CBFAML/ FLT3-ITD (n=75). Overall, 24 patients underwent allogeneic hematopoietic cell transplantation (HCT), 12 in first complete remission and 12 after relapse. Allogeneic HCT in first complete remission was not beneficial (P=0.60); however, allogeneic HCT seemed to improve median survival in relapsed patients compared to that of patients treated with chemotherapy (not reached vs. 0.6 years, respectively; P=0.002). Excluding patients with inv(16) with trisomy 22, our data indicate that compathe outcome of CBF-AML patients with FLT3-ITD may be inferior to that of patients without FLT3-ITD (based on previously published data), suggesting that prognostically CBF-AML patients with FLT3-ITD should not be classified as favorable-risk. FLT3-inhibitors may improve the outcome of these patients.
AB - The aim of this study was to evaluate the prognostic impact of FLT3-ITD in core-binding factor acute myeloid leukemia (CBFAML) in an international, multicenter survey of 97 patients of whom 52% had t(8;21)(q22;q22) and 48% had inv(16)(p13q22)/t(16;16)(p13;q22). The median age of the patients was 53 years (range, 19-81). Complete remission after anthracycline-based induction (n=86) and non-intensive therapy (n=11) was achieved in 97% and 36% of the patients, respectively. The median follow-up was 4.43 years (95% confidence interval [95% CI]: 3.35-7.39 years). The median survival after intensive and non-intensive treatment was not reached and 0.96 years, respectively. Among intensively treated patients, inv(16) with trisomy 22 (n=11) was associated with a favorable 4-year relapse-free survival rate of 80% (95% CI: 59-100%) as compared to 38% (95% CI: 27-54%; P=0.02) in all other patients with CBFAML/ FLT3-ITD (n=75). Overall, 24 patients underwent allogeneic hematopoietic cell transplantation (HCT), 12 in first complete remission and 12 after relapse. Allogeneic HCT in first complete remission was not beneficial (P=0.60); however, allogeneic HCT seemed to improve median survival in relapsed patients compared to that of patients treated with chemotherapy (not reached vs. 0.6 years, respectively; P=0.002). Excluding patients with inv(16) with trisomy 22, our data indicate that compathe outcome of CBF-AML patients with FLT3-ITD may be inferior to that of patients without FLT3-ITD (based on previously published data), suggesting that prognostically CBF-AML patients with FLT3-ITD should not be classified as favorable-risk. FLT3-inhibitors may improve the outcome of these patients.
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U2 - 10.3324/haematol.2021.278645
DO - 10.3324/haematol.2021.278645
M3 - Article
C2 - 34348451
AN - SCOPUS:85127922810
SN - 0390-6078
VL - 107
SP - 836
EP - 843
JO - Haematologica
JF - Haematologica
IS - 4
ER -