Umbilical cord blood transplantation is a suitable option for consolidation of acute myeloid leukemia with FLT3-ITD

Eckfeldt, Craig E.; Randall, Nicole; Shanley, Ryan; Yohe, Sophia; Bejanyan, Nelli; Dolan, Michelle; Warlick, Erica D.; Verneris, Michael R.; Brunstein, Claudio G.; Wagner, John E.; Weisdorf, Daniel J.; Üstün, Celalettin

doi:10.3324/haematol.2016.143628

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…Consistent with our large multicenter study, a single center study on 66 AML patients (22 FLT3+ and 44 FLT3-) receiving UCB HCT showed that the negative effect of FLT3+ AML was overcome by UCB HCT. ( 32 ) Two-year relapse rate was for FLT3+ AML 29% whereas 36% for FLT-AML, which led to LFS: 48% vs. 37%, and OS: 47% vs. 42% in FLT3+ AML vs. FLT3-AML, respectively). As the high risk nature of FLT3+ AML and the need for aggressive consolidation with allogeneic HCT is well recognized, our observation has major clinical implications for FLT3+ AML patients in CR after initial therapy.…”

Section: Discussionmentioning

confidence: 95%

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Outcomes of UCB transplantation are comparable in FLT3+ AML: results of CIBMTR, EUROCORD and EBMT collaborative analysis

et al. 2017

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Allogeneic hematopoietic cell transplantation (HCT) from siblings or unrelated donors (URD) during complete remission (CR) may improve leukemia-free survival (LFS) in FLT3+ acute myeloid leukemia (AML) that has poor prognosis due to high relapse rates. Umbilical cord blood (UCB) HCT outcomes are largely unknown in this population. We found that compared with sibling HCT, relapse risks were similar after UCB (n=126), (HR 0.86, p=0.54) and URD (n=91) (HR 0.81, p=0.43). UCB HCT was associated with statistically higher non-relapse mortality compared with sibling HCT (HR 2.32, p=0.02), but not vs. URD (HR 1.72, p=0.07). All three cohorts had statistically not significant 3-year LFS: 39% (95% CI 30–47) after UCB, 43% (95% CI 30–54) after sibling, and 50% (95% CI 40–60) after URD. Chronic GVHD rates were significantly lower after UCB compared with either sibling (HR 0.59, p=0.03) or URD (HR 0.49, p=0.001). Adverse factors for LFS included high leukocyte count at diagnosis and HCT during CR2. UCB is a suitable option for adults with FLT3+AML in the absence of an HLA-matched sibling and its immediate availability may be particularly important for FLT3+ AML where early relapse is common thus allowing HCT in CR1 when outcomes are best.

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Section: Discussionmentioning

confidence: 95%

“…( 24 , 30 , 31 ) The outcomes of patients with FLT3+ AML after UCB HCT are largely unknown except for a recent University of Minnesota report. ( 32 )…”

Section: Introductionmentioning

confidence: 99%