Does FLT3 mutation impact survival after hematopoietic stem cell transplantation for acute myeloid leukemia? A Center for International Blood and Marrow Transplant Research (CIBMTR) analysis.
Patients with FMS like tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia (AML) have a poor prognosis and are referred for early allogeneic hematopoietic stem cell transplantation (HCT).



Data from the Center for International Blood and Marrow Transplant Research (CIBMTR) were used to evaluate 511 adult patients with de novo AML who underwent HCT during 2008 through 2011 to determine whether FLT3 mutations had an impact on HCT outcomes.



In total, 158 patients (31%) had FLT3 mutations. Univariate and multivariate analyses revealed an increased risk of relapse at 3 years in the FLT3 mutated group compared with the wild-type (WT) group (38% [95% confidence interval (CI), 30%-45%] vs 28% [95% CI, 24%-33%]; P = .04; relative risk, 1.60 [95% CI, 1.15-2.22]; P = .0048). However, FLT3 mutation status was not significantly associated with nonrelapse mortality, leukemia-free survival, or overall survival. Although more patients in the FLT3 mutated group died from relapsed primary disease compared with those in the WT group (60% vs 46%), the 3-year overall survival rate was comparable for the 2 groups (mutated group: 49%; 95% CI, 40%-57%; WT group: 55%, 95% CI, 50%-60%; P = .20).



The current data indicate that FLT3 mutation status did not adversely impact overall survival after HCT, and about 50% of patients with this mutation who underwent HCT were long-term survivors. Cancer 2016;122:3005-3014. © 2016 American Cancer Society.
Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
Abhinav
A
Deol
Vanderbilt University Medical Center, Nashville, TN.
Salyka
S
Sengsayadeth
CIBMTR, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.|Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI.
Kwang Woo
KW
Ahn
CIBMTR, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Hai-Lin
HL
Wang
Department of Oncology, King Faisal Specialist Hospital Center & Research, Riydah, Saudi Arabia.
Mahmoud
M
Aljurf
Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Joseph Harry
JH
Antin
Hematology Branch, National Heart Lung and Blood Institute, Bethesda, MD.
Minoo
M
Battiwalla
Universitatsklinikum Carl Gustav Carus, Dresden, Germany.
Martin
M
Bornhauser
Department of Hematology, University Hospital, Grenoble, France.
Jean-Yves
JY
Cahn
Midwest Center for Cancer and Blood Disorders, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI.
Bruce
B
Camitta
Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA.
Yi-Bin
YB
Chen
Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Corey S
CS
Cutler
Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom.
Robert Peter
RP
Gale
Blood and Marrow Transplantation, Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS.
Siddhartha
S
Ganguly
CIBMTR, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Mehdi
M
Hamadani
Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
Yoshihiro
Y
Inamoto
Vanderbilt University Medical Center, Nashville, TN.
Madan
M
Jagasia
Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX.
Rammurti
R
Kamble
Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
John
J
Koreth
Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.
Hillard M
HM
Lazarus
Department of Medicine, University of Rochester Medical Center, Rochester, NY.
Jane
J
Liesveld
Division of Hematology and Transplant Center, Mayo Clinic Rochester.
Mark R
MR
Litzow
Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
David I
DI
Marks
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Taiga
T
Nishihori
Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.|Centre for Clinical Research, Sormland, Uppsala University, Uppsala, Sweden.
Richard F
RF
Olsson
Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
Ran
R
Reshef
Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel.
Jacob M
JM
Rowe
Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Ayman A
AA
Saad
Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research institute, Ottawa, Canada.
Mitchell
M
Sabloff
Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands.
Harry C
HC
Schouten
Division of Hematology and Oncology, Department of Medicine, University of North Carolina Health Care, Chapel Hill, NC.
Thomas C
TC
Shea
Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Robert J
RJ
Soiffer
Divsion of Onocology, Washington University School of Medicine, St. Louis, MO.
Geoffrey L
GL
Uy
Department of Hematology and Medical Oncology, Winship Cancer Insitute, Emory University, Atlanta, GA.
Edmond K
EK
Waller
Our Lady of Mercy Medical Center, Bronx, NY.
Peter H
PH
Wiernik
Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA.
Baldeep
B
Wirk
Fred Hutchinson Cancer Research Center, Seattle, WA.
Ann E
AE
Woolfrey
Department of Internal Medicine III, Universitatsklinkum Ulm, Ulm, Germany.
Donald
D
Bunjes
Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center- James, Columbus, OH.
Steven
S
Devine
Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH.
Marcos
M
de Lima
Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.
Brenda M
BM
Sandmaier
CIBMTR, NMDP/ Be The Match, Minneapolis, MN.
Dan
D
Weisdorf
Department of Hematology and Medical Oncology, Winship Cancer Insitute, Emory University, Atlanta, GA.
Hanna Jean
HJ
Khoury
CIBMTR, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Wael
W
Saber
D000293:Adolescent; D000328:Adult; D064591:Allografts; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics*
C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3
1 more; FMS-like tyrosine kinase 3 (FLT3); acute myeloid leukemia; allogeneic stem cell transplantation