Evolving patterns of care and outcomes in relapsed/refractory FLT3 mutated acute myeloid leukemia adult patients.

Leukemia & Lymphoma
Blanca BoludaPau Montesinos

Abstract

We have analyzed treatment patterns and outcomes of relapsed/refractory(R/R) FLT3mut AML adult patients registered in our institutional data base between 1998 and 2018. Overall, 147 patients were evaluable: 34 from 1998 to 2009, 113 from 2010 to 2018. Salvage treatments were intensive chemotherapy (n = 25, 74%), and supportive care (n = 9, 26%) in the 1998-2009 period, and intensive chemotherapy (n = 63, 56%), hypomethylating agent (n = 7, 6%), low-dose cytarabine-based (n = 8, 7%), clinical trial (n = 16, 14%) and supportive care (n = 19, 17%) in the 2010-2018 period. Complete remission (CR) or with incomplete recovery (CRi) rate was 44%, 49% among patients treated intensively (vs 30% with non-intensive p = 0.005). Median overall survival since first R/R was 5.8 months, and 16.3 months in subjects receiving an allo-HSCT in CR/CRi after first salvage (vs 3.8 in the remaining patients p < 0.0001). Clinical outcomes of R/R FLT3mut AML remain unsatisfactory. Inclusion in clinical trials and expanding options could lead to improved outcomes.

References

Nov 3, 2009·Leukemia Research·Farhad RavandiMiloslav Beran
Jun 9, 2016·The New England Journal of Medicine·Elli PapaemmanuilPeter J Campbell
Aug 31, 2017·Journal of Translational Medicine·Seah H LimVikram M Raghunathan
May 3, 2019·Nature Communications·Sibylle CocciardiKonstanze Döhner
Oct 31, 2019·The New England Journal of Medicine·Alexander E PerlMark J Levis

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