Allogeneic Stem-Cell Transplantation in Patients With NPM1-Mutated Acute Myeloid Leukemia: Results From a Prospective Donor Versus No-Donor Analysis of Patients After Upfront HLA Typing Within the SAL-AML 2003 Trial

被引：63

作者：

Roellig, Christoph ^{[1
]}

Bornhaeuser, Martin ^{[1
]}

Kramer, Michael ^{[1
]}

Thiede, Christian ^{[1
]}

Ho, Anthony D. ^{[3
]}

Kraemer, Alwin ^{[3
]}

Schaefer-Eckart, Kerstin ^{[4
]}

Wandt, Hannes ^{[4
]}

Haenel, Mathias ^{[5
]}

Einsele, Hermann ^{[6
]}

Aulitzky, Walter E. ^{[7
]}

Schmitz, Norbert ^{[8
]}

Berdel, Wolfgang E. ^{[9
]}

Stelljes, Matthias ^{[9
]}

Mueller-Tidow, Carsten ^{[10
]}

Krug, Utz ^{[9
]}

Platzbecker, Uwe ^{[1
]}

Wermke, Martin ^{[1
]}

Baldus, Claudia D. ^{[11
]}

Krause, Stefan W. ^{[12
]}

Stoelzel, Friedrich ^{[1
]}

von Bonin, Malte ^{[1
]}

Schaich, Markus ^{[1
]}

Serve, Hubert ^{[13
]}

Schetelig, Johannes ^{[1
,2
]}

Ehninger, Gerhard ^{[1
]}

机构：

[1] Tech Univ Dresden, Med Klin & Poliklin 1, Univ Klinikum, D-01062 Dresden, Germany

[2] German Bone Marrow Donor Ctr, DKMS, Dresden, Germany

[3] Med Univ Klin, Abt Innere Med 5, Heidelberg, Germany

[4] Klinikum Nurnberg, Med Klin 5, Nurnberg, Germany

[5] Klinikum Chemnitz, Klin Innere Med 3, Chemnitz, Germany

[6] Univ Klinikum Wurzburg, Med Klin & Poliklin 2, Wurzburg, Germany

[7] Robert Bosch Krankenhaus, Stuttgart, Germany

[8] ASKLEPIOS Klin St Georg, Abt Hamatol Onkol & Stammzelltransplantat, Hamburg, Germany

[9] Univ Klinikum Munster, Med Klin A, Munster, Germany

[10] Univ Klinikum Halle, Univ Klin & Poliklin Innere Med 4, Halle, Saale, Germany

[11] Charite, Med Klin 3, Charite Ctr 14, D-13353 Berlin, Germany

[12] Univ Klinikum Erlangen, Med Klin 5, Erlangen, Germany

[13] Univ Frankfurt Klinikum, Med Klin 2, Frankfurt, Germany

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2015年 / 33卷 / 05期

关键词：

ACUTE MYELOGENOUS LEUKEMIA; RESIDUAL DISEASE; NPM1; MUTATIONS; REMISSION; RESPONSES; RECOMMENDATIONS; PROGNOSIS; ADULTS;

D O I：

10.1200/JCO.2013.54.4973

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose The presence of a mutated nucleophosmin-1 gene (NPM1(mut)) in acute myeloid leukemia (AML) is associated with a favorable prognosis. To assess the predictive value with regard to allogeneic stem-cell transplantation (SCT), we compared the clinical course of patients with NPM1(mut) AML eligible for allogeneic SCT in a donor versus no-donor analysis. Patients and Methods Of 1,179 patients with AML (age 18 to 60 years) treated in the Study Alliance Leukemia AML 2003 trial, we identified all NPM1(mut) patients with an intermediate-risk karyotype. According to the trial protocol, patients were intended to receive an allogeneic SCT if an HLA-identical sibling donor was available. Patients with no available donor received consolidation or autologous SCT. We compared relapse-free survival (RFS) and overall survival (OS) depending on the availability of a suitable donor. Results Of 304 eligible patients, 77 patients had a sibling donor and 227 had no available matched family donor. The 3-year RFS rates in the donor and no-donor groups were 71% and 47%, respectively (P = .005); OS rates were 70% and 60%, respectively (P = .114). In patients with normal karyotype and no FLT3 internal tandem duplication (n = 148), the 3-year RFS rates in the donor and no-donor groups were 83% and 53%, respectively (P = .004); and the 3-year OS rates were 81% and 75%, respectively (P = .300). Conclusion Allogeneic SCT led to a significantly prolonged RFS in patients with NPM1(mut) AML. The absence of a statistically significant difference in OS is most likely a result of the fact that NPM1(mut) patients who experienced relapse responded well to salvage treatment. Allogeneic SCT in first remission has potent antileukemic efficacy and is a valuable treatment option in patients with NPM1(mut) AML with a sibling donor.

引用

页码：403 / 410

页数：8

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