Characteristics and outcome of patients with core-binding factor acute myeloid leukemia and FLT3-ITD: results from an international collaborative study

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Authors	KAYSER Sabine KRAMER Michael MARTINEZ-CUADRON David GRENET Justin METZELER Klaus H ŠUSTKOVÁ Zuzana LUSKIN Marlise R BRUNNER Andrew M ELLIOTT Michelle A GIL Cristina MARINI Sandra Casal RÁČIL Zdeněk CETKOVSKY Petr NOVAK Jan PERL Alexander E PLATZBECKER Uwe STOELZEL Friedrich HO Anthony D THIEDE Christian STONE Richard M ROELLIG Christoph MONTESINOS Pau SCHLENK Richard F LEVIS Mark J
Year of publication	2022
Type	Article in Periodical
Magazine / Source	Haematologica
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://haematologica.org/article/view/haematol.2021.278645
Doi	http://dx.doi.org/10.3324/haematol.2021.278645
Keywords	acute myeloid leukemia; FLT3-ITD
Description	The aim of this study was to evaluate the prognostic impact of FLT3-ITD in core-binding factor acute myeloid leukemia (CBF-AML) in an international, multicenter survey of 97 patients of whom 52% had t( 8; 21)(q22;q22) and 48% had inv(16)(p13q22)/t(16;16)(p13;q22). The median age of the patients was 53 years (range, 19-81). Complete remission after anthracycline-based induction (n= 86) and non-intensive therapy (n=11) was achieved in 97% and 36% of the patients, respectively. The median follow-up was 4.43 years (95% confidence interval [95% CI]: 3.35-7.39 years). The median survival after intensive and non-intensive treatment was not reached and 0.96 years, respectively. Among intensively treated patients, inv(16) with trisomy 22 (n=11) was associated with a favorable 4-year relapse-free survival rate of 80% (95% CI: 59-100%) as compared to 38% (95% CI: 27-54%; P=0.02) in all other patients with CBF-AML/FLT3-ITD (n= 75). Overall, 24 patients underwent allogeneic hematopoietic cell transplantation (HCT), 12 in first complete remission and 12 after relapse. Allogeneic HCT in first complete remission was not beneficial (P=0.60); however, allogeneic HCT seemed to improve median survival in relapsed patients compared to that of patients treated with chemotherapy (not reached vs. 0.6 years, respectively; P=0.002). Excluding patients with inv(16) with trisomy 22, our data indicate that the outcome of CBF-AML patients with FLT3-ITD may be inferior to that of patients without FLT3-ITD (based on previously published data), suggesting that prognostically CBF-AML patients with FLT3-ITD should not be classified favorable-risk. FLT3-inhibitors may improve the outcome of these patients.
Related projects:	Národní program studia mutací a klonality leukemických buněk u pacientů s akutní myeloidní leukémií