Citations 52
Does FLT3 mutation impact survival after hematopoietic stem cell transplantation for acute myeloid leukemia? A Center for International Blood and Marrow Transplant Research (CIBMTR) analysis
Deol, Abhinav , Sengsayadeth, Salyka, Ahn, Kwang Woo , Wang, Hailin , Aljurf, Mahmoud , Antin, Joseph H. , Cahn, Jean‐Yves , Camitta, Bruce, Chen, Yi‐Bin , Ganguly, Siddhartha , Inamoto, Yoshihiro , Jagasia, Madan , Kamble, Rammurti T., Koreth, John , Litzow, Mark R. , Marks, David I. , Olsson, Richard F. , Rowe, Jacob M. , Saad, Ayman , Sabloff, Mitchell , Schouten, Harry C. , Shea, Thomas C., Soiffer, Robert J. , Uy, Geoffrey L. , Waller, Edmund K. , Wiernik, Peter H. , Wirk, Baldeep , Woolfrey, Ann E. , Bunjes, Donald , Weisdorf, Dan, Khoury, H. Jean , Saber, Wael , Weisdorf, Daniel J. , Battiwalla, Minoo , Bornhäuser, Martin , Camitta, Bruce M., Cutler, Corey S. , Gale, Robert Peter , Hamadani, Mehdi , Lazarus, Hillard M. , Liesveld, Jane L. , Nishihori, Taiga , Reshef, Ran , Devine, Steven M. , Lima, Marcos de , Sandmaier, Brenda M , Saad, Ayman , Olsson, Richard F , Waller, Edmund K , Weisdorf, Dan , Uy, Geoffrey , Sabloff, Mitchell
Cancer | June 17, 2016 | Volume: 122 | Issue: 19 | Pages: 3005-3014
BACKGROUNDPatients with FMS like tyrosine kinase 3 (FLT3)‐mutated acute myeloid leukemia (AML) have a poor prognosis and are referred for early allogeneic hematopoietic stem cell transplantation (HCT).METHODSData from the Center for International Blood and Marrow Transplant Research (CIBMTR) were used to evaluate 511 adult patients with de novo AML who underwent HCT during 2008 through 2011 to determine whether FLT3 mutations had an impact on HCT outcomes.RESULTSIn total, 158 patients (31%) had FLT3 mutations. Univariate and multivariate analyses revealed an increased risk of relapse at 3 years in the FLT3 mutated group compared with the wild‐type (WT) group (38% [95% confidence interval (CI), 30%‐45%] vs 28% [95% CI, 24%‐33%]; P = .04; relative risk, 1.60 [95% CI, 1.15‐2.22]; P = .0048). However, FLT3 mutation status was not significantly associated with nonrelapse mortality, leukemia‐free survival, or overall survival. Although more patients in the FLT3 mutated group died from relapsed primary disease compared with those in the WT group (60% vs 46%), the 3‐year overall survival rate was comparable for the 2 groups (mutated group: 49%; 95% CI, 40%‐57%; WT group: 55%, 95% CI, 50%‐60%; P = .20).CONCLUSIONSThe current data indicate that FLT3 mutation status did not adversely impact overall survival after HCT, and about 50% of patients with this mutation who underwent HCT were long‐term survivors. Cancer 2016;122:3005‐3014. © 2016 American Cancer Society.
Hematopoietic Stem-Cell Transplantation for Advanced Systemic Mastocytosis
Üstün, Celalettin , Reiter, Andreas , Scott, Bart L. , Nakamura, Ryotaro , Damaj, Gandhi , Kreil, Sebastian, Shanley, Ryan , Baurmann, H., Doubek, Michael , Hsu, Jack W., Tholouli, Eleni , Gromke, Tanja , Godley, Lucy A. , Pagano, Livio , Gilman, Andrew L. , Wagner, Eva , Shwayder, Tor , Papadopoulos, Esperanza B. , Böhm, Alexandra, Vercellotti, Gregory M. , Lint, Maria Teresa Van, Rabitsch, Werner , Pullarkat, Vinod , Legrand, Faézeh, Yakoub‐Agha, Ibrahim , Saber, Wael , Barrett, J. Carl, Hermine, Olivier , Hägglund, Hans , Sperr, Wolfgang R. , Alyea, Edwin P. , Deeg, H. Joachim , Weisdorf, Daniel J. , Akin, Cem , Valent, Peter , Shore, Tsiporah, Baurmann, Herrad, Stuart, Robert, Gruhn, Bernd, Gilman, Andrew, Wagner, Eva Maria, Bornhäuser, Martin, Vercellotti, Gregory, Van Lint, Maria Teresa, Schmid, Christoph, Yakoub-Agha, Ibrahim, Barrett, John , Popat, Uday, Devine, Steven, Weisdorf, Daniel, Hogan, William J. , Perales, Miguel‐Angel , Shore, Tsiporah B. , Stuart, Robert K. , Gruhn, Bernd , Bornhäuser, Martin , Schmid, Christoph , Popat, Uday R , Devine, Steven M. , Weisdorf, Dan , Sperr, Wolfgang , Valent, Peter , Yakoub-Agha, Ibrahim , Hermine, Olivier , Akin, Cem , Godley, Lucy A
Journal of Clinical Oncology | August 26, 2014 | Volume: 32 | Issue: 29 | Pages: 3264-3274
PurposeAdvanced systemic mastocytosis (SM), a fatal hematopoietic malignancy characterized by drug resistance, has no standard therapy. The effectiveness of allogeneic hematopoietic stem-cell transplantation (alloHCT) in SM remains unknown.Patients and MethodsIn a global effort to define the value of HCT in SM, 57 patients with the following subtypes of SM were evaluated: SM associated with clonal hematologic non–mast cell disorders (SM-AHNMD; n = 38), mast cell leukemia (MCL; n = 12), and aggressive SM (ASM; n = 7). Median age of patients was 46 years (range, 11 to 67 years). Donors were HLA-identical (n = 34), unrelated (n = 17), umbilical cord blood (n = 2), HLA-haploidentical (n = 1), or unknown (n = 3). Thirty-six patients received myeloablative conditioning (MAC), and 21 patients received reduced-intensity conditioning (RIC).ResultsResponses in SM were observed in 40 patients (70%), with complete remission in 16 patients (28%). Twelve patients (21%) had stable disease, and five patients (9%) had primary refractory disease. Overall survival (OS) at 3 years was 57% for all patients, 74% for patients with SM-AHNMD, 43% for those with ASM, and 17% for those with MCL. The strongest risk factor for poor OS was MCL. Survival was also lower in patients receiving RIC compared with MAC and in patients having progression compared with patients having stable disease or response.ConclusionAlloHCT was associated with long-term survival in patients with advanced SM. Although alloHCT may be considered as a viable and potentially curative therapeutic option for advanced SM in the meantime, given that this is a retrospective analysis with no control group, the definitive role of alloHCT will need to be determined by a prospective trial.