Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade

Talha Badar, Hagop M. Kantarjian, Graciela M. Nogueras-Gonzalez, Gautam Borthakur, Guillermo Garcia Manero, Michael Andreeff, Marina Konopleva, Tapan M. Kadia, Naval Daver, William G. Wierda, Raja Luthra, Keyur Patel, Betul Oran, Richard Champlin, Farhad Ravandi, Jorge E. Cortes

Research output: Contribution to journalArticle

Abstract

AML with FLT3 ITD mutations are associated with poor outcome. We reviewed outcomes of patients with FLT3 ITD mutated AML to investigate trends over time. We analyzed 224 AML patients (excluding patients with core binding factor and acute promyelocytic leukemia) referred to our institution between 2000 and 2014. Patients were divided into five cohorts by era: 2000-2002 (Era 1, n=19), 2003-2005 (Era 2, n=41), 2006-2008 (Era 3, n=53), 2009-2011 (Era 4, n=55), and 2012-2014 (Era 5, n=56) to analyze differences in outcome. The baseline characteristics were not statistically different across Eras. The response rate (CR/CRp) from Era 1-5 was 68%, 49%, 72%, 73%, and 75%, respectively. The overall response rate (all Eras) with chemotherapy alone versus chemotherapy plus FLT3 inhibitor was 67% and 72.5%, respectively (P=0.4). The median time to relapse was 6, 3.6, 7.9, 8.1 months and not reached from Eras 1 through 5, respectively (P=0.001). The median OS has improved: 9.6, 7.6, 14.4, 15.7, and 17.8 month from Eras 1-5, respectively (P=<0.001). Stem cell transplant as a time-dependent variable, showed better OS in the univariate analysis (HR: 0.57, 95% CI: 0.39-0.84, P=0.004) but did not retained its significance in multivariate analysis (HR: 0.75, 95% CI: 0.50-1.13, P=0.16). Our data suggest improvement in outcome of FLT3 ITD mutated AML patients over the last 15 years. This is probably due to improvement in treatment strategies, including but not limited to integration of FLT3 inhibitors and increased use of SCT.

Original languageEnglish (US)
Pages (from-to)1065-1070
Number of pages6
JournalAmerican Journal of Hematology
Volume90
Issue number11
DOIs
StatePublished - Nov 2015
Externally publishedYes

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Acute Myeloid Leukemia
Core Binding Factors
Drug Therapy
Acute Promyelocytic Leukemia
Stem Cells
Multivariate Analysis
Transplants
Recurrence
Mutation
Therapeutics

ASJC Scopus subject areas

  • Hematology

Cite this

Badar, T., Kantarjian, H. M., Nogueras-Gonzalez, G. M., Borthakur, G., Garcia Manero, G., Andreeff, M., ... Cortes, J. E. (2015). Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade. American Journal of Hematology, 90(11), 1065-1070. https://doi.org/10.1002/ajh.24140

Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade. / Badar, Talha; Kantarjian, Hagop M.; Nogueras-Gonzalez, Graciela M.; Borthakur, Gautam; Garcia Manero, Guillermo; Andreeff, Michael; Konopleva, Marina; Kadia, Tapan M.; Daver, Naval; Wierda, William G.; Luthra, Raja; Patel, Keyur; Oran, Betul; Champlin, Richard; Ravandi, Farhad; Cortes, Jorge E.

In: American Journal of Hematology, Vol. 90, No. 11, 11.2015, p. 1065-1070.

Research output: Contribution to journalArticle

Badar, T, Kantarjian, HM, Nogueras-Gonzalez, GM, Borthakur, G, Garcia Manero, G, Andreeff, M, Konopleva, M, Kadia, TM, Daver, N, Wierda, WG, Luthra, R, Patel, K, Oran, B, Champlin, R, Ravandi, F & Cortes, JE 2015, 'Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade', American Journal of Hematology, vol. 90, no. 11, pp. 1065-1070. https://doi.org/10.1002/ajh.24140
Badar T, Kantarjian HM, Nogueras-Gonzalez GM, Borthakur G, Garcia Manero G, Andreeff M et al. Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade. American Journal of Hematology. 2015 Nov;90(11):1065-1070. https://doi.org/10.1002/ajh.24140
Badar, Talha ; Kantarjian, Hagop M. ; Nogueras-Gonzalez, Graciela M. ; Borthakur, Gautam ; Garcia Manero, Guillermo ; Andreeff, Michael ; Konopleva, Marina ; Kadia, Tapan M. ; Daver, Naval ; Wierda, William G. ; Luthra, Raja ; Patel, Keyur ; Oran, Betul ; Champlin, Richard ; Ravandi, Farhad ; Cortes, Jorge E. / Improvement in clinical outcome of FLT3 ITD mutated acute myeloid leukemia patients over the last one and a half decade. In: American Journal of Hematology. 2015 ; Vol. 90, No. 11. pp. 1065-1070.
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AU - Kantarjian, Hagop M.

AU - Nogueras-Gonzalez, Graciela M.

AU - Borthakur, Gautam

AU - Garcia Manero, Guillermo

AU - Andreeff, Michael

AU - Konopleva, Marina

AU - Kadia, Tapan M.

AU - Daver, Naval

AU - Wierda, William G.

AU - Luthra, Raja

AU - Patel, Keyur

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