We analyzed 140 patients with a median age of 51 years; 21\% had WBC >= 100 x 10(9)/L, and 52\% had an NPM1 co-mutation. Until 2018, 101 patients received chemotherapy; thereafter, 39 received 3+7+midostaurin. The overall CR rate was 64\%, higher in NPM1 mutant patients (73\%). Univariate analysis showed that NPM1 mutation (p = 0.032) and WBC < 100 x 109/L (p = 0.013) positively influenced the response, with a trend for FLT3i administration (p = 0.052). Multivariate analysis confirmed WBC count as an independent prognostic factor (p = 0.017). In CR1, 41/90 patients underwent allogeneic and 18 autologous transplantation. The median EFS was 1.1 vs. 1.6 years in autografted and allografted patients, respectively (p = 0.9). The one-year non-relapse mortality was 0.00\% for autologous and 28\% for allogeneic transplants (p = 0.007); CIR at 1 and 3 years was higher in autologous transplants (39\% vs. 15\% and 57\% vs. 21\%, p = 0.004). The median survival was not reached in the FLT3i group. Overall, 69 patients received stem cell transplantation (18 autologous, 51 allogeneic). Post-transplant FLT3i was resumed in eight patients, all alive after a median of 65 months. Allogeneic transplantation is crucial in FLT3-mutated AML, but the next challenge will be to identify which patients can benefit from transplants in CR1 and in which to intensify post-transplant therapy.
Real-Life Management of FLT3-Mutated AML: Single-Centre Experience over 24 Years / Capria, Saveria; Trisolini, Silvia Maria; Torrieri, Lorenzo; Amabile, Elena; Marsili, Giovanni; Piciocchi, Alfonso; Barberi, Walter; Iori, Anna Paola; Diverio, Daniela; Carmini, Daniela; Breccia, Massimo; Martelli, Maurizio; Minotti, Clara. - In: CANCERS. - ISSN 2072-6694. - 16:16(2024). [10.3390/cancers16162864]
Real-Life Management of FLT3-Mutated AML: Single-Centre Experience over 24 Years
Capria, Saveria;Torrieri, Lorenzo;Amabile, Elena;Marsili, Giovanni;Piciocchi, Alfonso;Barberi, Walter;Iori, Anna Paola;Breccia, Massimo;Martelli, Maurizio;
2024
Abstract
We analyzed 140 patients with a median age of 51 years; 21\% had WBC >= 100 x 10(9)/L, and 52\% had an NPM1 co-mutation. Until 2018, 101 patients received chemotherapy; thereafter, 39 received 3+7+midostaurin. The overall CR rate was 64\%, higher in NPM1 mutant patients (73\%). Univariate analysis showed that NPM1 mutation (p = 0.032) and WBC < 100 x 109/L (p = 0.013) positively influenced the response, with a trend for FLT3i administration (p = 0.052). Multivariate analysis confirmed WBC count as an independent prognostic factor (p = 0.017). In CR1, 41/90 patients underwent allogeneic and 18 autologous transplantation. The median EFS was 1.1 vs. 1.6 years in autografted and allografted patients, respectively (p = 0.9). The one-year non-relapse mortality was 0.00\% for autologous and 28\% for allogeneic transplants (p = 0.007); CIR at 1 and 3 years was higher in autologous transplants (39\% vs. 15\% and 57\% vs. 21\%, p = 0.004). The median survival was not reached in the FLT3i group. Overall, 69 patients received stem cell transplantation (18 autologous, 51 allogeneic). Post-transplant FLT3i was resumed in eight patients, all alive after a median of 65 months. Allogeneic transplantation is crucial in FLT3-mutated AML, but the next challenge will be to identify which patients can benefit from transplants in CR1 and in which to intensify post-transplant therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
