title: Presence of FLT3 mutations does not impair stem cell mobilization and feasibility of autologous peripheral blood stem cell transplantation in acute myeloid leukemia.
abstract: Fetal liver tyrosine kinase 3 (FLT3) mutations represent a powerful prognostic indicator in acute myeloid leukemia (AML). Further, interaction between FLT3 and its ligand plays a role in normal hematopoiesis. Accordingly, FLT3 mutations may affect mobilization of peripheral blood stem cells (PBSCs) and feasibility of autologous stem cell transplantation (ASCT) in AML. We analyzed the effect of FLT3 mutations on mobilization of CD34(+) cells and on PBASCT feasibility from 111 patients with AML, with a median age of 58 years and normal karyotype. Overall, 23 patients (21%) had FLT3 mutations. The complete remission rate was 74% and was not influenced by FLT3 mutations (73% for patients with FLT3(-) and 78% for those with FLT3(+); P= .78). The successful mobilization rate was 79% and was comparable for patients with FLT3(-) and with FLT3(+) (P = .42). Median numbers of CD34(+) cells collected were 7.6 x 10(6)/kg and 7.1 x 10(6)/kg for patients with FLT3(-) and those with FLT3(+), respectively (P = .64). Among 73 patients evaluated for mobilization, feasibility of ASCT was 71%, and there was no difference between patients with FLT3(-) (74%) and those with FLT3(+) (61%), P = .43. We conclude that the FLT3 mutations have no influence on mobilization of CD34(+) cells or on feasibility of PBASCT in patients with AML and normal karyotype.
authors.affiliation: Division of Haematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy. felicettoferrara@katamail.com <felicettoferrara@katamail.com>
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Palmieri
authors.forename: Filiberto
authors.initials: F
authors.lastname: Pollio
authors.forename: Catia
authors.initials: C
authors.lastname: Lo Pardo
authors.forename: Daniela
authors.initials: D
authors.lastname: Graziano
authors.forename: Maria
authors.initials: M
authors.lastname: Celentano
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: D'Amico
authors.forename: Laura
authors.initials: L
authors.lastname: Vicari
authors.forename: Barbara
authors.initials: B
authors.lastname: Izzo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D018572:Disease-Free Survival; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods / Q000401:mortality; D006801:Humans; D007621:Karyotyping / Q000379:methods; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D012074:Remission Induction; D012189:Retrospective Studies; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics*
chemical_list: D018952:Antigens, CD34; C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3