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Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Intermediate-risk cytogenetic acute myeloid leukemia with an internal tandem duplication of FLT3 (FLT3-ITD) is associated with a high risk of relapse, and is now a standard indication for allogeneic stem cell transplantation. Nevertheless, most studies supporting this strategy have been performed in...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ferrata Storti Foundation
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5792270/ https://www.ncbi.nlm.nih.gov/pubmed/29242299 http://dx.doi.org/10.3324/haematol.2017.178251 |
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author | Poiré, Xavier Labopin, Myriam Polge, Emmanuelle Passweg, Jakob Craddock, Charles Blaise, Didier Cornelissen, Jan J. Volin, Liisa Russell, Nigel H. Socié, Gérard Michallet, Mauricette Fegueux, Nathalie Chevallier, Patrice Brecht, Arne Hunault-Berger, Mathilde Mohty, Mohamad Esteve, Jordi Nagler, Arnon |
author_facet | Poiré, Xavier Labopin, Myriam Polge, Emmanuelle Passweg, Jakob Craddock, Charles Blaise, Didier Cornelissen, Jan J. Volin, Liisa Russell, Nigel H. Socié, Gérard Michallet, Mauricette Fegueux, Nathalie Chevallier, Patrice Brecht, Arne Hunault-Berger, Mathilde Mohty, Mohamad Esteve, Jordi Nagler, Arnon |
author_sort | Poiré, Xavier |
collection | PubMed |
description | Intermediate-risk cytogenetic acute myeloid leukemia with an internal tandem duplication of FLT3 (FLT3-ITD) is associated with a high risk of relapse, and is now a standard indication for allogeneic stem cell transplantation. Nevertheless, most studies supporting this strategy have been performed in young patients. To address the benefit of allogeneic transplantation in the elderly, we made a selection from the European Society for Blood and Marrow Transplantation registry of de novo intermediate-risk cytogenetic acute myeloid leukemia harboring FLT3-ITD in patients aged 60 or over and transplanted from a related or unrelated donor between January 2000 and December 2015. Two hundred and ninety-one patients were identified. Most patients received a reduced-intensity conditioning (82%), while donors consisted of an unrelated donor in 161 (55%) patients. Two hundred and twelve patients received their transplantation in first remission, 37 in second remission and 42 in a more advanced stage of the disease. The 2-year leukemia-free survival rate was 56% in patients in first remission, 22% in those in second remission and 10% in patients with active disease, respectively (P<0.005). Non-relapse mortality for the entire cohort was 20%. In multivariate analysis, disease status at transplantation was the most powerful predictor of worse leukemia-free survival, graft-versus-host disease and relapse-free survival, and overall survival. In this elderly population, age was not associated with outcome. Based on the current results, allogeneic transplantation translates into a favorable outcome in fit patients ≥ 60 with FLT3-ITD acute myeloid leukemia in first remission, similarly to current treatment recommendations for younger patients. |
format | Online Article Text |
id | pubmed-5792270 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Ferrata Storti Foundation |
record_format | MEDLINE/PubMed |
spelling | pubmed-57922702018-02-13 Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Poiré, Xavier Labopin, Myriam Polge, Emmanuelle Passweg, Jakob Craddock, Charles Blaise, Didier Cornelissen, Jan J. Volin, Liisa Russell, Nigel H. Socié, Gérard Michallet, Mauricette Fegueux, Nathalie Chevallier, Patrice Brecht, Arne Hunault-Berger, Mathilde Mohty, Mohamad Esteve, Jordi Nagler, Arnon Haematologica Article Intermediate-risk cytogenetic acute myeloid leukemia with an internal tandem duplication of FLT3 (FLT3-ITD) is associated with a high risk of relapse, and is now a standard indication for allogeneic stem cell transplantation. Nevertheless, most studies supporting this strategy have been performed in young patients. To address the benefit of allogeneic transplantation in the elderly, we made a selection from the European Society for Blood and Marrow Transplantation registry of de novo intermediate-risk cytogenetic acute myeloid leukemia harboring FLT3-ITD in patients aged 60 or over and transplanted from a related or unrelated donor between January 2000 and December 2015. Two hundred and ninety-one patients were identified. Most patients received a reduced-intensity conditioning (82%), while donors consisted of an unrelated donor in 161 (55%) patients. Two hundred and twelve patients received their transplantation in first remission, 37 in second remission and 42 in a more advanced stage of the disease. The 2-year leukemia-free survival rate was 56% in patients in first remission, 22% in those in second remission and 10% in patients with active disease, respectively (P<0.005). Non-relapse mortality for the entire cohort was 20%. In multivariate analysis, disease status at transplantation was the most powerful predictor of worse leukemia-free survival, graft-versus-host disease and relapse-free survival, and overall survival. In this elderly population, age was not associated with outcome. Based on the current results, allogeneic transplantation translates into a favorable outcome in fit patients ≥ 60 with FLT3-ITD acute myeloid leukemia in first remission, similarly to current treatment recommendations for younger patients. Ferrata Storti Foundation 2018-02 /pmc/articles/PMC5792270/ /pubmed/29242299 http://dx.doi.org/10.3324/haematol.2017.178251 Text en Copyright© 2018 Ferrata Storti Foundation Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for commercial purposes is not allowed without permission in writing from the publisher. |
spellingShingle | Article Poiré, Xavier Labopin, Myriam Polge, Emmanuelle Passweg, Jakob Craddock, Charles Blaise, Didier Cornelissen, Jan J. Volin, Liisa Russell, Nigel H. Socié, Gérard Michallet, Mauricette Fegueux, Nathalie Chevallier, Patrice Brecht, Arne Hunault-Berger, Mathilde Mohty, Mohamad Esteve, Jordi Nagler, Arnon Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title | Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title_full | Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title_fullStr | Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title_full_unstemmed | Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title_short | Allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
title_sort | allogeneic stem cell transplantation benefits for patients ≥ 60 years with acute myeloid leukemia and flt3 internal tandem duplication: a study from the acute leukemia working party of the european society for blood and marrow transplantation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5792270/ https://www.ncbi.nlm.nih.gov/pubmed/29242299 http://dx.doi.org/10.3324/haematol.2017.178251 |
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