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Prognostic impact of low allelic ratio FLT3-ITD and NPM1 mutation in acute myeloid leukemia.


ABSTRACT: In the opinion of the European LeukemiaNet (ELN), nucleophosmin member 1 gene mutation (NPM1 mut)-positive acute myeloid leukemia (AML) with an fms-like kinase 3-internal tandem duplication (FLT3-ITD) allele ratio (AR) <0.5 (low AR) has a favorable prognosis, and allogeneic hematopoietic stem cell transplant (allo-HSCT) in the first complete remission (CR1) period is not actively recommended. We studied 147 patients with FLT3-ITD gene mutation-positive AML, dividing them into those with low AR and those with AR of ?0.5 (high AR), and examined the prognostic impact according to allo-HSCT in CR1. Although FLT3-ITD AR and NPM1 mut are used in the prognostic stratification, we found that NPM1 mut-positive AML with FLT3-ITD low AR was not associated with favorable outcome (overall survival [OS], 41.3%). Moreover, patients in this group who underwent allo-HSCT in CR1 had a significantly more favorable outcome than those who did not (relapse-free survival [RFS] P = .013; OS P = .003). Multivariate analysis identified allo-HSCT in CR1 as the sole favorable prognostic factor (RFS P < .001; OS P < .001). The present study found that prognosis was unfavorable in NPM1 mut-positive AML with FLT3-ITD low AR when allo-HSCT was not carried out in CR1.

SUBMITTER: Sakaguchi M 

PROVIDER: S-EPMC6199656 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Prognostic impact of low allelic ratio <i>FLT3-</i>ITD and <i>NPM1</i> mutation in acute myeloid leukemia.

Sakaguchi Masahiro M   Yamaguchi Hiroki H   Najima Yuho Y   Usuki Kensuke K   Ueki Toshimitsu T   Oh Iekuni I   Mori Sinichiro S   Kawata Eri E   Uoshima Nobuhiko N   Kobayashi Yutaka Y   Kako Shinichi S   Tajika Kenji K   Gomi Seiji S   Shono Katsuhiro K   Kayamori Kensuke K   Hagihara Masao M   Kanda Junya J   Uchiyama Hitoji H   Kuroda Junya J   Uchida Naoyuki N   Kubota Yasushi Y   Kimura Shinya S   Kurosawa Saiko S   Nakajima Nana N   Marumo Atsushi A   Omori Ikuko I   Fujiwara Yusuke Y   Yui Shunsuke S   Wakita Satoshi S   Arai Kunihito K   Kitano Tomoaki T   Kakihana Kazuhiko K   Kanda Yoshinobu Y   Ohashi Kazuteru K   Fukuda Takahiro T   Inokuchi Koiti K  

Blood advances 20181001 20


In the opinion of the European LeukemiaNet (ELN), nucleophosmin member 1 gene mutation (<i>NPM1</i> mut)-positive acute myeloid leukemia (AML) with an fms-like kinase 3-internal tandem duplication (<i>FLT3</i>-ITD) allele ratio (AR) <0.5 (low AR) has a favorable prognosis, and allogeneic hematopoietic stem cell transplant (allo-HSCT) in the first complete remission (CR1) period is not actively recommended. We studied 147 patients with <i>FLT3</i>-ITD gene mutation-positive AML, dividing them int  ...[more]

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