TY - JOUR
T1 - Cytogenetic risk classification maintains its prognostic significance in transplanted FLT3-ITD mutated acute myeloid leukemia patients
T2 - On behalf of the acute leukemia working party/European society of blood and marrow transplantation
AU - Nagler, Arnon
AU - Labopin, Myriam
AU - Craddock, Charles
AU - Socié, Gerard
AU - Yakoub-Agha, Ibrahim
AU - Gedde-Dahl, Tobias
AU - Niittyvuopio, Riitta
AU - Byrne, Jennifer Louise
AU - Cornelissen, Jan J.
AU - Labussière-Wallet, Hélène
AU - Arcese, William
AU - Milpied, Noel
AU - Esteve, Jordi
AU - Canaani, Jonathan
AU - Mohty, Mohamad
N1 - Funding Information:
We thank all the European Society for Blood and Marrow Transplantation (EBMT) centers (Appendix S1: Contributing Centers) and national registries for contributing patients to this study; we also thank the data managers and the patients who contributed their data.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutational status is a pivotal prognosticator in acute myeloid leukemia (AML) patients and significantly increases the risk of disease relapse. However, it remains unclear whether in FLT3-ITD patients referred for allogeneic stem cell transplantation (allo-SCT), baseline cytogenetics significantly impacts clinical outcome. Using the European Society of Blood and Marrow Transplantation registry, we performed a retrospective analysis of 1631 FLT3-ITD AML patients who underwent allo-SCT with the aim of determining the influence of cytogenetic risk category on patient outcomes. Median patient age was 49 years and median follow-up duration was 36 months. Two-year leukemia-free survival (LFS) and incidence of relapse were 54% and 31.6%, respectively. Non-relapse mortality was experienced by 14.4% with a 2-year overall survival (OS) of 60.1%. On multivariate analysis, LFS was significantly lower in patients with intermediate and adverse risk cytogenetics compared with those with favorable risk cytogenetics, (hazard ratio [HR] = 1.48, 95% confidence interval [CI], 1.06–2.06; p =.02), and (HR = 01.65, 95% CI, 1.13–2.40; p =.009), respectively. OS was significantly lower in patients with adverse risk cytogenetics compared with patients with favorable risk cytogenetics (HR = 1.74, 95% CI, 1.16–2.61; p =.008) with a trend toward lower OS in patients with intermediate risk cytogenetics compared to those with favorable risk cytogenetics (HR = 1.43, 95% CI, 1.00–2.05; p =.052). In addition, adverse risk patients and intermediate risk patients experienced higher relapse rates compared with favorable risk patients (HR = 1.83, 95% CI, 1.13–2.94; p =.013 and HR = 1.82, 95% CI, 1.19–2.77; p =.005). Overall, cytogenetic studies aid in refinement of risk stratification in transplanted FLT3-ITD AML patients.
AB - FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutational status is a pivotal prognosticator in acute myeloid leukemia (AML) patients and significantly increases the risk of disease relapse. However, it remains unclear whether in FLT3-ITD patients referred for allogeneic stem cell transplantation (allo-SCT), baseline cytogenetics significantly impacts clinical outcome. Using the European Society of Blood and Marrow Transplantation registry, we performed a retrospective analysis of 1631 FLT3-ITD AML patients who underwent allo-SCT with the aim of determining the influence of cytogenetic risk category on patient outcomes. Median patient age was 49 years and median follow-up duration was 36 months. Two-year leukemia-free survival (LFS) and incidence of relapse were 54% and 31.6%, respectively. Non-relapse mortality was experienced by 14.4% with a 2-year overall survival (OS) of 60.1%. On multivariate analysis, LFS was significantly lower in patients with intermediate and adverse risk cytogenetics compared with those with favorable risk cytogenetics, (hazard ratio [HR] = 1.48, 95% confidence interval [CI], 1.06–2.06; p =.02), and (HR = 01.65, 95% CI, 1.13–2.40; p =.009), respectively. OS was significantly lower in patients with adverse risk cytogenetics compared with patients with favorable risk cytogenetics (HR = 1.74, 95% CI, 1.16–2.61; p =.008) with a trend toward lower OS in patients with intermediate risk cytogenetics compared to those with favorable risk cytogenetics (HR = 1.43, 95% CI, 1.00–2.05; p =.052). In addition, adverse risk patients and intermediate risk patients experienced higher relapse rates compared with favorable risk patients (HR = 1.83, 95% CI, 1.13–2.94; p =.013 and HR = 1.82, 95% CI, 1.19–2.77; p =.005). Overall, cytogenetic studies aid in refinement of risk stratification in transplanted FLT3-ITD AML patients.
UR - http://www.scopus.com/inward/record.url?scp=85122155876&partnerID=8YFLogxK
U2 - 10.1002/ajh.26442
DO - 10.1002/ajh.26442
M3 - Article
C2 - 34978724
AN - SCOPUS:85122155876
SN - 0361-8609
VL - 97
SP - 274
EP - 282
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 3
ER -