Clinical study of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation in the treatment of FLT3-ITD + acute myeloid leukemia with normal karyotype
10.3760/cma.j.issn.0253-2727.2023.03.009
- VernacularTitle:诱导化疗序贯异基因造血干细胞移植治疗FLT3-ITD突变阳性伴正常染色体核型急性髓系白血病的临床研究
- Author:
Fang LI
1
;
Yanping LIU
;
Han ZHU
;
Ming HONG
;
Sixuan QIAN
;
Yu ZHU
;
Wenyi SHEN
;
Lijuan CHEN
;
Guangsheng HE
;
Hanxin WU
;
Hua LU
;
Jianyong LI
;
Kourong MIAO
Author Information
1. 南京医科大学第一附属医院，江苏省人民医院血液科，南京 210029
- Keywords:
Leukemia, myeloid, acute;
FLT3-ITD mutation;
Allogeneic hematopoietic stem cell transplantation;
Prognosis
- From:
Chinese Journal of Hematology
2023;44(3):230-235
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of FLT3-ITD + acute myeloid leukemia (AML) with normal karyotype. Methods:The clinical data of FLT3-ITD + AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. Results:The study included 49 patients with FLT3-ITD +AML, 31 males, and 18 females, with a median age of 46 (16-59) years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT (transplantation group) . The median follow-up time was 465 days, the one-year overall survival (OS) from diagnosis was (70.0 ± 7.4) %, and one-year disease-free survival (DFS) was (70.3±7.4) %. The one-year OS was significantly different between the transplantation group and the non-transplantation group [ (85.2 ± 7.9) % vs (52.6 ± 12.3) %, P=0.049]. but one-year DFS [ (84.7 ± 8.1) % vs (55.2 ± 11.9) %, P=0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD + ( P>0.05) . There were 12 patients with high-frequency FLT3-ITD + in the transplantation and the non-transplantation groups, respectively. The one-year OS [ (68.8 ± 15.7) % in the transplantation group vs (26.2 ± 15.3) % in the non-transplantation group, P=0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group vs (27.8±15.8) % in the non-transplantation group, P=0.032] were significantly different between the two groups. Conclusion:Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD + patients, particularly those with FLT3-ITD high-frequency mutation.
