Does FLT3 mutation impact survival after hematopoietic stem cell transplantation for acute myeloid leukemia? A Center for International Blood and Marrow Transplant Research (CIBMTR) analysis

Abhinav Deol, Salyka Sengsayadeth, Kwang Woo Ahn, Hai-Lin Wang, Mahmoud D. Aljurf, Joseph Harry Antin, Minoo Battiwalla, Martin Bornhauser, Jean-Yves Cahn, Bruce M. Camitta, Yi-Bin Chen, Corey S. Cutler, Robert Peter Gale, Siddhartha Ganguly, Mehdi Hamadani, Yoshihiro Inamoto, Madan H. Jagasia, Rammurti T. Kamble, John Koreth, Hillard M. LazarusJane L. Liesveld, Mark R. Litzow, David I. Marks, Taiga Nishihori, Richard F. Olsson, Ran Reshef, Jacob M. Rowe, Ayman Saad, Mitchell Sabloff, Hendricus Schouten, Thomas C. Shea, Robert J. Soiffer, Geoffrey L. Uy, Edmond K Waller, Peter H. Wiernik, Baldeep M. Wirk, Ann E. Woolfrey, Donald Bunjes, Steven M. Devine, Marcos J. de Lima, Brenda M Sandmaier, Dan Weisdorf, Hanna Jean Khoury, Wael Saber

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Patients with FMS like tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia (AML) have a poor prognosis and are referred for early allogeneic hematopoietic stem cell transplantation (HCT).

METHODS: Data from the Center for International Blood and Marrow Transplant Research (CIBMTR) were used to evaluate 511 adult patients with de novo AML who underwent HCT during 2008 through 2011 to determine whether FLT3 mutations had an impact on HCT outcomes.

RESULTS: In total, 158 patients (31%) had FLT3 mutations. Univariate and multivariate analyses revealed an increased risk of relapse at 3 years in the FLT3 mutated group compared with the wild-type (WT) group (38% [95% confidence interval (CI), 30%-45%] vs 28% [95% CI, 24%-33%]; P = .04; relative risk, 1.60 [95% CI, 1.15-2.22]; P = .0048). However, FLT3 mutation status was not significantly associated with nonrelapse mortality, leukemia-free survival, or overall survival. Although more patients in the FLT3 mutated group died from relapsed primary disease compared with those in the WT group (60% vs 46%), the 3-year overall survival rate was comparable for the 2 groups (mutated group: 49%; 95% CI, 40%-57%; WT group: 55%, 95% CI, 50%-60%; P = .20).

CONCLUSIONS: The current data indicate that FLT3 mutation status did not adversely impact overall survival after HCT, and about 50% of patients with this mutation who underwent HCT were long-term survivors. Cancer 2016;122:3005-3014. © 2016 American Cancer Society.

Original languageEnglish
Pages (from-to)3005-3014
Number of pages10
JournalCancer
Volume122
Issue number19
DOIs
Publication statusPublished - Oct 2016

Keywords

  • Adolescent
  • Adult
  • Allografts
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Myeloid, Acute
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Staging
  • Prognosis
  • Survival Rate
  • Survivors
  • Young Adult
  • fms-Like Tyrosine Kinase 3
  • Journal Article
  • COMPLETE REMISSION
  • TANDEM DUPLICATIONS
  • acute myeloid leukemia
  • AML
  • 12 TRIALS
  • PROGNOSIS
  • DISTINCT
  • CYTOGENETICS
  • ALLOGENEIC TRANSPLANTATION
  • allogeneic stem cell transplantation
  • GENE
  • FMS-like tyrosine kinase 3 (FLT3)
  • 1 more
  • MINIMAL RESIDUAL DISEASE

Cite this

Deol, A., Sengsayadeth, S., Ahn, K. W., Wang, H-L., Aljurf, M. D., Antin, J. H., Battiwalla, M., Bornhauser, M., Cahn, J-Y., Camitta, B. M., Chen, Y-B., Cutler, C. S., Gale, R. P., Ganguly, S., Hamadani, M., Inamoto, Y., Jagasia, M. H., Kamble, R. T., Koreth, J., ... Saber, W. (2016). Does FLT3 mutation impact survival after hematopoietic stem cell transplantation for acute myeloid leukemia? A Center for International Blood and Marrow Transplant Research (CIBMTR) analysis. Cancer, 122(19), 3005-3014. https://doi.org/10.1002/cncr.30140