诱导化疗序贯异基因造血干细胞移植治疗FLT3-ITD突变阳性伴正常染色体核型急性髓系白血病的临床研究

OBJECTIVE: To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation（allo-HSCT）in the treatment of FLT3-ITD(+) acute myeloid leukemia（AML）with normal karyotype. METHODS: The clinical data of FLT3-ITD(+) AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. RESULTS: The study included 49 patients with FLT3-ITD(+)AML, 31 males, and 18 females, with a median age of 46（16–59）years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT（transplantation group）. The median follow-up time was 465 days, the one-year overall survival（OS）from diagnosis was（70.0 ± 7.4）％, and one-year disease-free survival（DFS）was（70.3±7.4）％. The one-year OS was significantly different between the transplantation group and the non-transplantation group［（85.2 ± 7.9）％ vs（52.6 ± 12.3）％, P＝0.049］. but one-year DFS［（84.7 ± 8.1）％ vs（55.2 ± 11.9）％, P＝0.061］was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD(+)（P>0.05）. There were 12 patients with high-frequency FLT3-ITD(+) in the transplantation and the non-transplantation groups, respectively. The one-year OS［（68.8 ± 15.7）％ in the transplantation group vs（26.2 ± 15.3）％ in the non-transplantation group, P＝0.027］and one-year DFS［（45.5 ± 21.3）％ in the transplantation group vs（27.8±15.8）％ in the non-transplantation group, P＝0.032］were significantly different between the two groups. CONCLUSION: Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD(+) patients, particularly those with FLT3-ITD high-frequency mutation.