Measurable residual disease, FLT3-ITD mutation, and disease status have independent prognostic influence on outcome of allogeneic stem cell transplantation in NPM1-mutated acute myeloid leukemia

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TitreMeasurable residual disease, FLT3-ITD mutation, and disease status have independent prognostic influence on outcome of allogeneic stem cell transplantation in NPM1-mutated acute myeloid leukemia
Type de publicationJournal Article
Year of Publication2022
AuteursHamed RAl, Labopin M, Daguindau E, Niittyvuopio R, Huynh A, Socie G, Srour M, Bourhis JHenri, Kroeger N, Tholouli E, Choi G, Poire X, Martin H, Rubio M-T, Jindra P, Blaise D, Beelen D, Labussiere-Wallet H, Nagler A, Bazarbachi A, Mohty M
JournalCANCER MEDICINE
Volume11
Pagination1068-1080
Date PublishedFEB
Type of ArticleArticle
ISSN2045-7634
Mots-clésacute myeloid leukemia, FLT3-ITD, minimal residual disease, NPM-1 mutation
Résumé

{Nucleophosmin-1 (NPM1) mutations in acute myeloid leukemia (AML) confer a survival advantage in the absence of FLT3-internal tandem duplication (FLT3-ITD). Here, we investigated the main predictors of outcome after allogeneic hematopoietic stem cell transplantation (allo-HCT). We identified 1572 adult (age >= 18 year) patients with NPM1-mutated AML in first complete remission (CR1:78%) or second complete remission (CR2:22%) who were transplanted from matched sibling donors (30.8%) or unrelated donors (57.4%) between 2007 and 2019 at EBMT participating centers. Median follow-up for survivors was 23.7 months. FLT3-ITD was present in 69.3% of patients and 39.2% had detectable minimal/measurable residual disease (MRD) at transplant. In multivariate analysis, relapse incidence (RI) and leukemia-free survival (LFS) were negatively affected by concomitant FLT3-ITD mutation (HR 1.66 p = 0.0001, and HR 1.53, p < 0.0001, respectively), MRD positivity at transplant (HR 2.18, p < 10(-5) and HR 1.71, p < 10(-5), respectively), and transplant in CR2 (HR 1.36
DOI10.1002/cam4.4218