Abstract 6014
Background
The impact of FLT3ITDmut on post-transplant outcome of adult AML remains controversial. A decreased leukemia-free survival (LFS) after allogeneic hematopoietic stem cell transplantation (HSCT) for adult AML in complete remission (CR) was observed in EBMT analysis but not CIBMTR. The impact of FLT3ITDmut on AML patients in later disease stage, as well as the influence of concurrent NPM1 mutation on post-transplant outcome, is less well studied.
Methods
In this study, only adults aged ≥ 18 years with a diagnosis of de novo AML who received allogeneic peripheral blood stem cell transplantation and with known FLT3ITD and NPM1 status in the registry were included. Kaplan-Meier estimates were used to calculate LFS and overall survival (OS). Multivariate analyses for LFS and OS were performed using Cox proportional hazards model.
Results
For patients who received transplant in CR1, the 2 year LFS, OS, and relapse incidence (RI) were 33.1%, 48.7%, and 56%, respectively, for patients of FLT3ITDmutNPM1wt, which are much inferior to patients of FLT3ITDmutNPM1mut (74.3%, 77.8%, and 25.7%, respectively) and patients of FLT3ITDwt (53.5%, 71%, and 37.3%, respectively). In multivariate analysis, patients of FLT3ITDmutNPM1wt, but not patients of FLT3ITDmutNPM1mut, were associated with significant poor LFS (HR 2.672, p = 0.007) and OS (HR 2.439, p = 0.038) compared with patients of FLT3ITDwt. For patients who received transplant after CR1, FLT3ITDmut was associated with significant poor LFS (HR 1.775, p = 0.013) and OS (HR 1.716, p = 0.028) compared with patients of FLT3ITDwt. NPM1 mutation dose not influence the outcome.
Conclusions
For patients in CR1, the impact of FLT3ITD is markedly modified by NPM1 status. The post-transplant outcome remains poor for patients of FLT3ITDmutNPM1wt and highlights the need for a novel approach (such as maintenance FLT3ITD inhibitor after transplant). For patients after CR1, the post-transplant outcome is very poor for patients of FLT3ITDmut and is independent of NPM1 status.
Clinical trial identification
Editorial acknowledgement
The author thanks all the centers participating in the TBMTR. The report is on behalf of the Taiwan society of blood and bone marrow transplantation.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
3909 - Spectrum of pathogenic germline mutations in Chinese lung cancer patients through next-generation sequencing
Presenter: Ying Huang
Session: Poster Display session 1
Resources:
Abstract
3061 - Poor prognostic impact of NTRK2 gene variation in Esophageal Squamous Cell Carcinoma
Presenter: Ye Chen
Session: Poster Display session 1
Resources:
Abstract
4735 - Mutation profile of Tibetan lung cancer revealed by Whole Exome Sequencing
Presenter: Xin Wang
Session: Poster Display session 1
Resources:
Abstract
5236 - Synergistic activity between niraparib and chemotherapy in colorectal cancer: molecular determinants from a preclinical model
Presenter: Pietro Paolo Vitiello
Session: Poster Display session 1
Resources:
Abstract
4051 - cRGDfK (cRGD) conjugated Pyropheophor¬bide-a (Pyro), a new tumor photodynamic agent, is highly accumulated and specific in tumor cell killing
Presenter: Fengwei Wang
Session: Poster Display session 1
Resources:
Abstract
859 - The expression of MMR, CD133 and the presence of p53 wt predict the response to Cabazitaxel in malignant neural tumors cell lines.
Presenter: Kevin Doello
Session: Poster Display session 1
Resources:
Abstract
2497 - IKS01, a next generation antibody drug conjugate (ADC) designed to be efficacious in tumors with low and moderate levels of folate receptor expression
Presenter: Jenny Thirlway
Session: Poster Display session 1
Resources:
Abstract
1636 - Novel Non-Camptothecin Compounds with Antiproliferative Activities against Breast Cancer Cells
Presenter: Wen-shan Li
Session: Poster Display session 1
Resources:
Abstract
3443 - Sensitization of estrogen receptor-positive breast cancer cells to tamoxifen by novel epi-oligomycin A
Presenter: Margarita Yastrebova
Session: Poster Display session 1
Resources:
Abstract
840 - Autophagy inhibition enhances leflunomide-induced cytotoxicity in human bladder cancer cells
Presenter: Li Cheng
Session: Poster Display session 1
Resources:
Abstract