title: Is allogeneic transplantation really the best treatment for FLT3/ITD-positive acute myeloid leukemia? A systematic review.
abstract: Fetal liver tyrosine kinase 3 (FLT3)-internal tandem duplications (ITDs) has been used as a powerful adverse prognostic indicator for acute myeloid leukemia (AML) in any age group. Evidence is mixed regarding the effects of allogeneic transplantation (allo-HSCT) in first complete remission (CR) for patients with FLT3/ITD AML. To fill this gap, this study provides a systematic review and meta-analysis of patients with FLT3/ITD AML receiving HSCT. A search of PubMed, Embase, and OVID yielded 1706 abstracts, two researchers screening the trials based on inclusion and exclusion criteria, and assessed the methodology quality independently. Meta-analysis showed that compared with chemotherapy, both allo-HSCT and autologous hematopoietic cell transplantation (auto-HSCT) can reduce the relapse rate (p < 0.01) and improve both the OS (p < 0.01) and DFS (p < 0.01). But when compared allo-HSCT with auto-HSCT, the OS (p = 0.27) and DFS (p = 0.19) have no statistical significance, and only the relapse indicator has statistical significance, p < 0.01. Based on the results, we can conclude that allo-HSCT is an efficient therapy approach for patients with FLT3/ITD AML. Chemotherapy cannot change the poor prognosis. Auto-HSCT can improve OS and DFS, but it cannot reduce the relapse rate.
authors.affiliation: Department of Hematology, Xinqiao Hospital, Third Military Medical University, ChongQing, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Ma
authors.forename: Yazhou
authors.initials: Y
authors.lastname: Wu
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Shen
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Zeng
authors.forename: Peiyan
authors.initials: P
authors.lastname: Kong
mesh_terms: D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000201:enzymology / Q000601:surgery*; D011379:Prognosis; D012074:Remission Induction; D014184:Transplantation, Homologous; D051941:fms-Like Tyrosine Kinase 3 / Q000378:metabolism*
chemical_list: D051941:fms-Like Tyrosine Kinase 3
keywords: FLT3/ITD; acute myeloid leukemia; allogeneic transplantation; hematopoietic stem cell transplantation; meta-analysis