dc.creator | Brunet, Salut | |
dc.creator | Labopin, Myriam | |
dc.creator | Esteve, Jordi | |
dc.creator | Cornelissen, Jan | |
dc.creator | Socie, Gerard | |
dc.creator | Iori, Anna P. | |
dc.creator | Verdonck, Leo F. | |
dc.creator | Volin, Liisa | |
dc.creator | Gratwohl, Alois | |
dc.creator | Sierra, Jorge | |
dc.creator | Mohty, Mohamad | |
dc.creator | Rocha, Vanderson | |
dc.date.accessioned | 2013-09-23T15:14:51Z | |
dc.date.accessioned | 2018-07-04T15:57:17Z | |
dc.date.available | 2013-09-23T15:14:51Z | |
dc.date.available | 2018-07-04T15:57:17Z | |
dc.date.created | 2013-09-23T15:14:51Z | |
dc.date.issued | 2012 | |
dc.identifier | JOURNAL OF CLINICAL ONCOLOGY, ALEXANDRIA, v. 30, n. 7, pp. 735-741, 2012 | |
dc.identifier | 0732-183X | |
dc.identifier | http://www.producao.usp.br/handle/BDPI/33598 | |
dc.identifier | 10.1200/JCO.2011.36.9868 | |
dc.identifier | http://dx.doi.org/10.1200/JCO.2011.36.9868 | |
dc.identifier.uri | http://repositorioslatinoamericanos.uchile.cl/handle/2250/1629653 | |
dc.description.abstract | Purpose Patients with acute myeloid leukemia (AML) and FLT3/internal tandem duplication (FLT3/ITD) have poor prognosis if treated with chemotherapy only. Whether this alteration also affects outcome after allogeneic hematopoietic stem-cell transplantation (HSCT) remains uncertain. Patients and Methods We analyzed 206 patients who underwent HLA-identical sibling and matched unrelated HSCTs reported to the European Group for Blood and Marrow Transplantation with a diagnosis of AML with normal cytogenetics and data on FLT3/ITD (present: n = 120, 58%; absent: n = 86, 42%). Transplantations were performed in first complete remission (CR) after myeloablative conditioning. Results Compared with FLT3/ITD-negative patients, FLT3/ITD-positive patients had higher median leukocyte count at diagnosis (59 v 21 x 10(9)/L; P < .001) and shorter interval from CR to transplantation (87 v 99 days; P = .04). Other characteristics were similar in the two groups. At 2 years, relapse incidence (RI; +/- standard deviation) was higher (30% +/- 5% v 16% +/- 5%; P = .006) and leukemia-free survival (LFS) lower (58% +/- 5% v 71% +/- 6%; P = .04) in FLT3/ITD-positive compared with FLT3/ITD-negative patients. In multivariate analyses, FLT3/ITD led to increased RI (hazard ratio [HR], 3.4; 95% CI, 1.46 to 7.94; P = .005), as did older age, female sex, shorter interval between CR and transplantation, and higher number of chemotherapy courses before achieving CR. FLT3/ITD positivity was associated with decreased LFS (HR, 0.37; 95% CI, 0.19 to 0.73; P = .002), along with older age and higher number of chemotherapy courses before achieving CR. Conclusion FLT3/ITD adversely affected the outcome of HSCT in the same direction it does after chemotherapy; despite this, more than half of the patients harboring this mutation who received transplants were alive and leukemia free at 2 years. To further improve the results, use of FLT3 inhibitors before or after HSCT deserves investigation. | |
dc.language | eng | |
dc.publisher | AMER SOC CLINICAL ONCOLOGY | |
dc.publisher | ALEXANDRIA | |
dc.relation | JOURNAL OF CLINICAL ONCOLOGY | |
dc.rights | Copyright AMER SOC CLINICAL ONCOLOGY | |
dc.rights | closedAccess | |
dc.title | Impact of FLT3 Internal Tandem Duplication on the Outcome of Related and Unrelated Hematopoietic Transplantation for Adult Acute Myeloid Leukemia in First Remission: A Retrospective Analysis | |
dc.type | Artículos de revistas | |