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

This study examines the aggregate influence of those factors on outcome post-transplant in NPM1-mutated AML. AbstractNucleophosmin-1 (NPM1) mutations in acute myeloid leukemia (AML) confer a survival advantage in the absence ofFLT3-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 withNPM1-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 concomitantFLT3-ITD mutation (HR 1.66p = 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,p = 0.026, and HR 1.26,p = 0.033, respectively), but positively affected by Karnofsky score ≥90 (HR 0.74,p = 0.012, and HR 0.7,p = 0.0002, respectively). Overall survival (OS) was also negatively influenced by concomitantFLT3-ITD (HR 1.6,p = 0.0001), MRD positivity at transplant (HR 1.61,p &...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: RESEARCH ARTICLE Source Type: research