FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutational status is a pivotal prognosticator in acute myeloid leukemia (AML) patients and significantly increases the risk of disease relapse. However, it remains unclear whether in FLT3-ITD patients referred for allogeneic stem cell transplantation (allo-SCT), baseline cytogenetics significantly impacts clinical outcome. Using the European Society of Blood and Marrow Transplantation registry, we performed a retrospective analysis of 1631 FLT3-ITD AML patients who underwent allo-SCT with the aim of determining the influence of cytogenetic risk category on patient outcomes. Median patient age was 49 years and median follow-up duration was 36 months. Two-year leukemia-free survival (LFS) and incidence of relapse were 54% and 31.6%, respectively. Non-relapse mortality was experienced by 14.4% with a 2-year overall survival (OS) of 60.1%. On multivariate analysis, LFS was significantly lower in patients with intermediate and adverse risk cytogenetics compared with those with favorable risk cytogenetics, (hazard ratio [HR] = 1.48, 95% confidence interval [CI], 1.06–2.06; p = .02), and (HR = 01.65, 95% CI, 1.13–2.40; p = .009), respectively. OS was significantly lower in patients with adverse risk cytogenetics compared with patients with favorable risk cytogenetics (HR = 1.74, 95% CI, 1.16–2.61; p = .008) with a trend toward lower OS in patients with intermediate risk cytogenetics compared to those with favorable risk cytogenetics (HR = 1.43, 95% CI, 1.00–2.05; p = .052). In addition, adverse risk patients and intermediate risk patients experienced higher relapse rates compared with favorable risk patients (HR = 1.83, 95% CI, 1.13–2.94; p = .013 and HR = 1.82, 95% CI, 1.19–2.77; p = .005). Overall, cytogenetic studies aid in refinement of risk stratification in transplanted FLT3-ITD AML patients.

中文翻译：

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细胞遗传学风险分类在移植的 FLT3-ITD 突变的急性髓性白血病患者中保持其预后意义：代表急性白血病工作组/欧洲血液和骨髓移植学会

FMS 样酪氨酸激酶 3 内部串联重复 ( FLT3-ITD ) 突变状态是急性髓性白血病 (AML) 患者的关键预后指标，并显着增加疾病复发的风险。然而，尚不清楚在FLT3-ITD患者中转诊进行同种异体干细胞移植 (allo-SCT) 时，基线细胞遗传学是否显着影响临床结果。使用欧洲血液和骨髓移植协会登记处，我们对 1631 FLT3-ITD进行了回顾性分析接受 allo-SCT 的 AML 患者，目的是确定细胞遗传学风险类别对患者预后的影响。患者中位年龄为 49 岁，中位随访时间为 36 个月。两年无白血病生存率 (LFS) 和复发率分别为 54% 和 31.6%。非复发死亡率为 14.4%，2 年总生存期 (OS) 为 60.1%。在多变量分析中，与具有良好风险细胞遗传学的患者相比，具有中等和不良细胞遗传学风险的患者的 LFS 显着降低（风险比 [HR] = 1.48，95% 置信区间 [CI]，1.06–2.06；p  = .02） , 和 (HR = 01.65, 95% CI, 1.13–2.40; p = .009），分别。与具有良好细胞遗传学风险的患者相比，具有不良细胞遗传学风险的患者的 OS 显着降低（HR = 1.74，95% CI，1.16-2.61；p  = .008），与那些具有中等风险细胞遗传学的患者相比，OS 趋于降低具有有利的细胞遗传学风险（HR = 1.43, 95% CI, 1.00–2.05; p  = .052）。此外，与有利风险患者相比，不利风险患者和中等风险患者的复发率更高（HR = 1.83, 95% CI, 1.13–2.94；p  = .013 和 HR = 1.82, 95% CI, 1.19–2.77；p  = .005)。总体而言，细胞遗传学研究有助于完善移植的 FLT3-ITD AML 患者的风险分层。