Survival improvement of patients with FLT3 mutated acute myeloid leukemia : results from a prospective 9 years cohort

Guadalupe Oñate, Marta Pratcorona, Ana Garrido, Alícia Artigas-Baleri, Alex Bataller, Mar Tormo, Montserrat Arnan, Susana Vives Polo, Rosa Coll, Olga Salamero, Ferran Vall-Llovera, Antonia Sampol, Antoni Garcia, Marta Cervera, Sara Garcia-Avila, Joan Bargay, Xavier Ortín, Josep Nomdedeu, Jordi Esteve Reyner, Jorge Sierra

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Resumen

Midostaurin added to intensive chemotherapy is the standard of care for acute myeloid leukemia (AML) with FLT3 mutations (FLT3 mut). We analyzed the impact of midostaurin in 227 FLT3 mut-AML patients included in the AML-12 prospective trial for fit patients ≤70 years (#NCT04687098). Patients were divided into an early (2012-2015) and late (2016-2020) cohorts. They were uniformly treated except for the addition of midostaurin in 71% of late group patients. No differences were observed in response rates or the number of allotransplants between groups. Outcome was improved in the late period: 2-year relapse incidence decreased from 42% vs 29% in early vs late group (p = 0.024) and 2-year overall survival (OS) improved from 47% vs 61% (p = 0.042), respectively. The effect of midostaurin was evident in NPM1 mut patients (n = 151), with 2-yr OS of 72% (exposed) vs 50% (naive) patients (p = 0.011) and mitigated FLT3 -ITD allelic ratio prognostic value: 2-yr OS with midostaurin was 85% and 58% in low and high ratio patients (p = 0.049) vs 67% and 39% in naive patients (p = 0.005). In the wild-type NPM1 subset (n = 75), we did not observe significant differences between both study periods. In conclusion, this study highlights the improved outcome of FLT3 mut AML fit patients with the incorporation of midostaurin.
Idioma originalInglés
PublicaciónBlood Cancer Journal
Volumen13
DOI
EstadoPublicada - 2023

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