Li F, Liu Y P, Zhu H, Hong M, Qian S X, Zhu Y, Shen W Y, Chen L J, He G S, Wu H X, Lu H, Li J Y, Miao K R
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Xue Ye Xue Za Zhi. 2023 Mar 14;44(3):230-235. doi: 10.3760/cma.j.issn.0253-2727.2023.03.009.
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. 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. 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) % (52.6 ± 12.3) %, =0.049]. but one-year DFS [ (84.7 ± 8.1) % (55.2 ± 11.9) %, =0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD(+) (>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 (26.2 ± 15.3) % in the non-transplantation group, =0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group (27.8±15.8) % in the non-transplantation group, =0.032] were significantly different between the two groups. Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD(+) patients, particularly those with FLT3-ITD high-frequency mutation.
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