A large-scale study of 511 adults undergoing transplant for de novo acute myeloid leukemia (AML) in first or second complete remission with (n=158) or without (n=353) FLT3 mutations has shown that those with the mutation have a significantly higher incidence of relapse, but that overall survival is comparable in the two patient cohorts. The researchers analyzed transplants between 2008 and 2011 reported to CIBMTR (Center for International Blood and Marrow Transplant Research). Median age (range) for the FLT3-negative and FLT3-positive patients was 46 years (18-60) and 47 years (18-60), respectively. Myeloablative conditioning regimens were used in 86.5% of transplants and non-myeloablative/reduced-intensity regimens were used in 13.5% of transplants.
Median follow-up of survivors was 37 months (range, 12-65). At 2 years post-transplant, patients with the FLT3 mutation experienced a significantly higher incidence of relapse than FLT3-negative patients: 38% vs. 28%, respectively (p=0.01). However, 2-year overall survival was comparable in FLT3+ and FLT3- patients: 49% vs. 55%, respectively (p=0.13).