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Allografting

Allo-SCT for high-risk AML-CR1 in the molecular era: impact of FLT3/ITD outweighs the conventional markers

Bone Marrow Transplantation volume 47, pages 1535–1537 (2012)Cite this article

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Abstract

Seventy-nine patients with AML in CR1 received allo-SCT between May 2006 and May 2011, and the prognostic impact of FMS-like tyrosine kinase 3/internal tandem duplication (FLT3/ITD) mutation was evaluated in the context of other clinical prognostic factors. Patients with FLT3/ITD+ AML had significantly inferior DFS (2-year DFS: 19% vs 64%, P=0.0027), increased risk of relapse (1-year: 59% vs 19%, P=0.01), and a trend towards decreased OS (P=0.08) compared with patients without FLT3/ITD. Multivariate analysis confirmed FLT3/ITD+ independently predicted a shorter DFS (HR, 3.0; 95% CI), 1.4–6.5; P=0.01) and increased risk of relapse (HR, 4.9; 95% CI, 2.0–12.3, P=0.01). Time to relapse in patients with FLT3/ITD+ was short with 100-day cumulative risk of 45% (95% CI, 33–57). Our data suggest that the poor prognostic implication of FLT3/ITD positivity remains even after early allo-SCT in patients with FLT3/ITD+ AML, and patients remain at high risk of early relapse. FLT3/ITD positivity also outweighs other conventional prognostic markers in predicting relapse.

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Acknowledgements

We would like to thank Janice Tracy for her contribution to this project.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Section of Hematology and Stem Cell Transplantation, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA

    S M Sengsayadeth, M Jagasia, B G Engelhardt, A Kassim, S A Strickland, S Goodman, C Lucid, J P Greer & B N Savani

  2. Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA

    C L Vnencak-Jones

Authors
  1. S M Sengsayadeth
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  2. M Jagasia
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  4. A Kassim
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  5. S A Strickland
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  6. S Goodman
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  7. C Lucid
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  8. C L Vnencak-Jones
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  9. J P Greer
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  10. B N Savani
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Correspondence to B N Savani.

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Sengsayadeth, S., Jagasia, M., Engelhardt, B. et al. Allo-SCT for high-risk AML-CR1 in the molecular era: impact of FLT3/ITD outweighs the conventional markers. Bone Marrow Transplant 47, 1535–1537 (2012). https://doi.org/10.1038/bmt.2012.88

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