Oct 23, 2018
Prognostic impact of low allelic ratio FLT3-ITD and NPM1 mutation in acute myeloid leukemia.
Blood advances
- Volume
- 2
- Number
- 20
- First page
- 2744
- Last page
- 2754
- Language
- English
- Publishing type
- Research paper (scientific journal)
- 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.
- Link information
- ID information
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- DOI : 10.1182/bloodadvances.2018020305
- ISSN : 2473-9529
- Pubmed ID : 30341082
- Pubmed Central ID : PMC6199656