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

• Published in: Cancer Vol. 122; no. 19; pp. 3005 - 3014
• Main Authors: Deol, Abhinav, Sengsayadeth, Salyka, Ahn, Kwang Woo, Wang, Hai‐Lin, Aljurf, Mahmoud, Antin, Joseph Harry, Battiwalla, Minoo, Bornhauser, Martin, Cahn, Jean‐Yves, Camitta, Bruce, Chen, Yi‐Bin, Cutler, Corey S., Gale, Robert Peter, Ganguly, Siddhartha, Hamadani, Mehdi, Inamoto, Yoshihiro, Jagasia, Madan, Kamble, Rammurti, Koreth, John, Lazarus, Hillard M., Liesveld, Jane, Litzow, Mark R., Marks, David I., Nishihori, Taiga, Olsson, Richard F., Reshef, Ran, Rowe, Jacob M., Saad, Ayman A., Sabloff, Mitchell, Schouten, Harry C., Shea, Thomas C., Soiffer, Robert J., Uy, Geoffrey L., Waller, Edmond K., Wiernik, Peter H., Wirk, Baldeep, Woolfrey, Ann E., Bunjes, Donald, Devine, Steven, de Lima, Marcos, Sandmaier, Brenda M., Weisdorf, Dan, Khoury, Hanna Jean, Saber, Wael
• Format: Journal Article
• Language: English
• Published: United States 01.10.2016
• Subjects: 1 more; acute myeloid leukemia; Adolescent; Adult; allogeneic stem cell transplantation; Allografts; Female; fms-Like Tyrosine Kinase 3 - genetics; FMS‐like tyrosine kinase 3 (FLT3); Follow-Up Studies; Hematopoietic Stem Cell Transplantation - mortality; Humans; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Male; Medicin och hälsovetenskap; Middle Aged; Mutation - genetics; Neoplasm Staging; Prognosis; Survival Rate; Survivors; Young Adult; allogeneic stem cell transplantation; acute myeloid leukemia; FMS-like tyrosine kinase 3 (FLT3); 1 more
• ISSN: 0008-543X; 1097-0142; 1097-0142
• DOI: 10.1002/cncr.30140

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. FMS‐like tyrosine kinase 3 (FLT3) mutation status does not have an impact on overall survival after allogeneic hematopoietic stem cell transplantation. Pre‐emptive strategies to reduce relapse need to be investigated in patients who have FLT3 mutations to further improve outcomes after hematopoietic stem cell transplantation.