2026-06-14T03:54:03Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/161362024-11-30T00:30:43Zcom_20.500.12105_2173com_20.500.12105_2051col_20.500.12105_19597

00925njm 22002777a 4500 dc Ayala, Rosa author Carreño-Tarragona, Gonzalo author Barragán, Eva author Boluda, Blanca author Larráyoz, María J author Chillón, María Carmen author Carrillo-Cruz, Estrella author Bilbao, Cristina author Sánchez-García, Joaquín author Bernal, Teresa author Martinez-Cuadron, David author Gil, Cristina author Serrano, Josefina author Rodriguez-Medina, Carlos author Bergua, Juan author Pérez-Simón, José A author Calbacho, María author Alonso-Domínguez, Juan M author Labrador, Jorge author Tormo, Mar author Amigo, Maria Luz author Herrera-Puente, Pilar author Rapado, Inmaculada author Sargas, Claudia author Vazquez, Iria author Calasanz, María J author Gomez-Casares, Teresa author García-Sanz, Ramón author Sanz, Miguel A author Martinez-Lopez, Joaquin author Montesinos, Pau author 2022-11-24 FLT3−ITD results in a poor prognosis in terms of overall survival (OS) and relapse-free survival (RFS) in acute myeloid leukemia (AML). However, the prognostic usefulness of the allelic ratio (AR) to select post-remission therapy remains controversial. Our study focuses on the prognostic impact of FLT3−ITD and its ratio in a series of 2901 adult patients treated intensively in the pre-FLT3 inhibitor era and reported in the PETHEMA registry. A total of 579 of these patients (20%) harbored FLT3−ITD mutations. In multivariate analyses, patients with an FLT3−ITD allele ratio (AR) of >0.5 showed a lower complete remission (CR rate) and OS (HR 1.47, p = 0.009), while AR > 0.8 was associated with poorer RFS (HR 2.1; p < 0.001). Among NPM1/FLT3−ITD-mutated patients, median OS gradually decreased according to FLT3−ITD status and ratio (34.3 months FLT3−ITD-negative, 25.3 months up to 0.25, 14.5 months up to 0.5, and 10 months ≥ 0.5, p < 0.001). Post-remission allogeneic transplant (allo-HSCT) resulted in better OS and RFS as compared to auto-HSCT in NPM1/FLT3−ITD-mutated AML regardless of pre-established AR cutoff (≤0.5 vs. >0.5). Using the maximally selected log-rank statistics, we established an optimal cutoff of FLT3−ITD AR of 0.44 for OS, and 0.8 for RFS. We analyzed the OS and RFS according to FLT3−ITD status in all patients, and we found that the group of FLT3−ITD-positive patients with AR < 0.44 had similar 5-year OS after allo-HSCT or auto-HSCT (52% and 41%, respectively, p = 0.86), but worse RFS after auto-HSCT (p = 0.01). Among patients with FLT3−ITD AR > 0.44, allo-HSCT was superior to auto-HSCT in terms of OS and RFS. This study provides more evidence for a better characterization of patients with AML harboring FLT3−ITD mutations. Cancers (Basel). 2022;14(23):5799. 10.3390/cancers14235799 2072-6694 Cancers 36497281 http://hdl.handle.net/20.500.12105/16136 FLT3-ITD mutation and ratio real-world outcomes ACUTE MYELOID LEUKEMIA PROGNOSIS OUTCOME DEATH RELAPSE SURVIVAL Impact of FLT3-ITD Mutation Status and Its Ratio in a Cohort of 2901 Patients Undergoing Upfront Intensive Chemotherapy: A PETHEMA Registry Study.