論文

査読有り 国際誌
2018年10月23日

Prognostic impact of low allelic ratio FLT3-ITD and NPM1 mutation in acute myeloid leukemia.

Blood advances
  • Masahiro Sakaguchi
  • ,
  • Hiroki Yamaguchi
  • ,
  • Yuho Najima
  • ,
  • Kensuke Usuki
  • ,
  • Toshimitsu Ueki
  • ,
  • Iekuni Oh
  • ,
  • Sinichiro Mori
  • ,
  • Eri Kawata
  • ,
  • Nobuhiko Uoshima
  • ,
  • Yutaka Kobayashi
  • ,
  • Shinichi Kako
  • ,
  • Kenji Tajika
  • ,
  • Seiji Gomi
  • ,
  • Katsuhiro Shono
  • ,
  • Kensuke Kayamori
  • ,
  • Masao Hagihara
  • ,
  • Junya Kanda
  • ,
  • Hitoji Uchiyama
  • ,
  • Junya Kuroda
  • ,
  • Naoyuki Uchida
  • ,
  • Yasushi Kubota
  • ,
  • Shinya Kimura
  • ,
  • Saiko Kurosawa
  • ,
  • Nana Nakajima
  • ,
  • Atsushi Marumo
  • ,
  • Ikuko Omori
  • ,
  • Yusuke Fujiwara
  • ,
  • Shunsuke Yui
  • ,
  • Satoshi Wakita
  • ,
  • Kunihito Arai
  • ,
  • Tomoaki Kitano
  • ,
  • Kazuhiko Kakihana
  • ,
  • Yoshinobu Kanda
  • ,
  • Kazuteru Ohashi
  • ,
  • Takahiro Fukuda
  • ,
  • Koiti Inokuchi

2
20
開始ページ
2744
終了ページ
2754
記述言語
英語
掲載種別
DOI
10.1182/bloodadvances.2018020305

In the opinion of the European LeukemiaNet (ELN), nucleophosmin member 1 gene mutation (NPM1 mut)-positive acute myeloid leukemia (AML) with an fms-like kinase 3-internal tandem duplication (FLT3-ITD) allele ratio (AR) <0.5 (low AR) has a favorable prognosis, and allogeneic hematopoietic stem cell transplant (allo-HSCT) in the first complete remission (CR1) period is not actively recommended. We studied 147 patients with FLT3-ITD gene mutation-positive AML, dividing them into those with low AR and those with AR of ≥0.5 (high AR), and examined the prognostic impact according to allo-HSCT in CR1. Although FLT3-ITD AR and NPM1 mut are used in the prognostic stratification, we found that NPM1 mut-positive AML with FLT3-ITD low AR was not associated with favorable outcome (overall survival [OS], 41.3%). Moreover, patients in this group who underwent allo-HSCT in CR1 had a significantly more favorable outcome than those who did not (relapse-free survival [RFS] P = .013; OS P = .003). Multivariate analysis identified allo-HSCT in CR1 as the sole favorable prognostic factor (RFS P < .001; OS P < .001). The present study found that prognosis was unfavorable in NPM1 mut-positive AML with FLT3-ITD low AR when allo-HSCT was not carried out in CR1.

リンク情報
DOI
https://doi.org/10.1182/bloodadvances.2018020305
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30341082
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199656

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