FLT3 mutational status is an independent risk factor for adverse outcomes after allogeneic transplantation in AML.
FLT3 mutational status is an independent risk factor for adverse outcomes after allogeneic transplantation in AML.
复制标题
FLT3突变状态是AML同种异体移植后不良后果的独立危险因素。
DOI：
10.1038/bmt.2015.170
复制
发表时间：
2016-04
影响因子：
4.8
通讯作者：
Choi SW
中科院分区：
文献类型：
--
作者：
Song Y;Magenau J;Li Y;Braun T;Chang L;Bixby D;Hanauer DA;Chughtai KA;Gatza E;Couriel D;Goldstein S;Pawarode A;Reddy P;Riwes M;Connelly J;Harris A;Kitko C;Levine J;Yanik G;Parkin B;Choi SW
Allogeneic HCT has been increasingly used in the setting of FLT3 mutated AML. However, its role in conferring durable relapse-free intervals remains in question. Herein, we sought to investigate FLT3 mutational status on transplant outcomes. We conducted a retrospective cohort study of 262 consecutive AML patients who underwent first-time allogeneic HCT (2008-2014), of whom 171 had undergone FLT3-ITD mutational testing. FLT3 mutated AML was associated with nearly twice the relapse risk (RR) compared with those without FLT3 mutation 3 years post-HCT (63% vs. 37%, P<0.001), and with a shorter median time to relapse (100 vs. 121 days). FLT3 mutational status remained significantly associated with this outcome after controlling for patient, disease, and transplant-related risk factors (P<0.05). Multivariate analysis showed a significant association of FLT3 mutation with increased 3-year RR (HR 3.63, 95% CI: 2.13, 6.19, P<0.001), and inferior disease-free survival (HR 2.05, 95% CI: 1.29, 3.27, P<0.01) and overall survival (HR 1.92, 95% CI: 1.14, 3.24, P<0.05). These data demonstrate high risk of early relapse after allogeneic HCT for FLT3 mutated AML that translates into adverse disease-free and overall survival outcomes. Additional targeted and coordinated interventions are needed to maintain durable remission after allogeneic HCT in this high-risk population.
