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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ferrata Storti Foundation 2018
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.
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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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