Allogeneic stem cell transplantation benefits for patients >= 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation - Aix-Marseille Université Access content directly
Journal Articles Haematologica Year : 2018

Allogeneic stem cell transplantation benefits for patients >= 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Xavier Poire
  • Function : Author
Myriam Labopin
Emmanuelle Polge
  • Function : Author
Jakob Passweg
  • Function : Author
Charles Craddock
  • Function : Author
Jan J. Cornelissen
  • Function : Author
Liisa Volin
  • Function : Author
Nigel H. Russell
  • Function : Author
Gerard Socie
  • Function : Author
Mauricette Michallet
  • Function : Author
Nathalie Fegueux
  • Function : Author
Patrice Chevallier
Arne Brecht
  • Function : Author
Mathilde Hunault-Berger
Mohamad Mohty
Jordi Esteve
Arnon Nagler

Abstract

Intermediate-risk cytogenetic acute myeloid leukemia with an internal tandem duplication of FLT3 (FLT3-ITD) is associated with a high risk of relapse, and is now a standard indication for allogeneic stem cell transplantation. Nevertheless, most studies supporting this strategy have been performed in young patients. To address the benefit of allogeneic transplantation in the elderly, we made a selection from the European Society for Blood and Marrow Transplantation registry of de novo intermediate-risk cytogenetic acute myeloid leukemia harboring FLT3-ITD in patients aged 60 or over and transplanted from a related or unrelated donor between January 2000 and December 2015. Two hundred and ninety-one patients were identified. Most patients received a reduced-intensity conditioning (82%), while donors consisted of an unrelated donor in 161 (55%) patients. Two hundred and twelve patients received their transplantation in first remission, 37 in second remission and 42 in a more advanced stage of the disease. The 2-year leukemia-free survival rate was 56% in patients in first remission, 22% in those in second remission and 10% in patients with active disease, respectively (P<0.005). Non-relapse mortality for the entire cohort was 20%. In multivariate analysis, disease status at transplantation was the most powerful predictor of worse leukemia-free survival, graft-versus-host disease and relapse-free survival, and overall survival. In this elderly population, age was not associated with outcome. Based on the current results, allogeneic transplantation translates into a favorable outcome in fit patients >= 60 with FLT3-ITD acute myeloid leukemia in first remission, similarly to current treatment recommendations for younger patients.

Dates and versions

hal-02143587 , version 1 (29-05-2019)

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Xavier Poire, Myriam Labopin, Emmanuelle Polge, Jakob Passweg, Charles Craddock, et al.. Allogeneic stem cell transplantation benefits for patients >= 60 years with acute myeloid leukemia and FLT3 internal tandem duplication: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica, 2018, 103 (2), pp.256-265. ⟨10.3324/haematol.2017.178251⟩. ⟨hal-02143587⟩

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