Favorable outcome of patients with acute myeloid leukemia harboring a low-allelic burden FLT3-ITD mutation and concomitant NPM1 mutation: Relevance to post-remission therapy

Marta Pratcorona, Salut Brunet, Josep Nomdedéu, Josep Maria Ribera, Mar Tormo, Rafael Duarte, Lourdes Escoda, Ramon Guàrdia, M. Paz Queipo De Llano, Olga Salamero, Joan Bargay, Carmen Pedro, Josep Maria Martí, Montserrat Torrebadell, Marina Díaz-Beyá, Mireia Camós, Dolors Colomer, Montserrat Hoyos, Jorge Sierra, Jordi Esteve

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142 Citations (Scopus)

Abstract

© 2013 by The American Society of Hematology. Risk associated to FLT3 internal tandem duplication (FLT3-ITD) in patients with acute myeloid leukemia (AML) may depend on mutational burden and its interaction with other mutations. We analyzed the effect of FLT3-ITD/FLT3 wild-type (FLT3wt) ratio depending on NPM1 mutation (NPM1mut) in 303 patients with intermediate-risk cytogenetics AML treated with intensive chemotherapy. Among NPM1mut patients, FLT3wt and low ratio (<0.5) subgroups showed similar overall survival, relapse risk, and leukemia-free survival, whereas high ratio (‡0.5) patients had a worse outcome. In NPM1wt AML, FLT3-ITD subgroups showed a comparable outcome, with higher risk of relapse and shortened overall survival than FLT3wt patients. Allogeneic stem cell transplantation in CR1 was associated with a reduced relapse risk in all molecular subgroups with the exception of NPM1mut AML with absent or low ratio FLT3-ITD. In conclusion, effect of FLT3 burden is modulated by NPM1 mutation, especially in patients with a low ratio.
Original languageEnglish
Pages (from-to)2734-2738
JournalBlood
Volume121
Issue number14
DOIs
Publication statusPublished - 1 Jan 2013

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