Survival improvement of patients with FLT3 mutated acute myeloid leukemia

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 di...

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Detalles Bibliográficos
Autores: Oñate, Guadalupe|||0000-0003-2180-2371, Pratcorona, Marta|||0000-0001-6375-596X, Garrido Diaz, Ana|||0000-0002-5297-8946, Artigas-Baleri, Alícia|||0000-0003-0486-268X, Bataller, Alex|||0000-0002-6085-2745, Tormo, Mar|||0000-0001-9622-1649, Arnan, Montserrat, Vives Polo, Susana|||0000-0003-2217-5285, Coll, Rosa|||0000-0003-0560-1254, Salamero, Olga|||0000-0003-3237-0025, Vall-Llovera, Ferran|||0000-0002-0718-5955, Sampol, Antonia|||0000-0001-7465-6203, Garcia Guiñón, Antoni, Cervera, Marta, Garcia-Avila, Sara|||0000-0002-9293-2029, Bargay, Joan|||0000-0002-6739-3916, Ortín, Xavier, Nomdedeu Guinot, Jose Francisco|||0000-0003-3399-346X, Esteve Reyner, Jordi|||0000-0002-8056-648X, Sierra, Jorge|||0000-0002-7966-0356
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:279359
Acceso en línea:https://ddd.uab.cat/record/279359
https://dx.doi.org/urn:doi:10.1038/s41408-023-00839-1
Access Level:acceso abierto
Palabra clave:Acute myeloid leukaemia
Translational research
Descripción
Sumario: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.

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