The cooccurrence of NPM1,FLT3-ITD,and DNMT3A mutations(i.e.,triple mutation)is related to dismal prognosis in patients with acute myeloid leukemia(AML)receiving chemotherapy alone.In this multicenter retrospective coh...The cooccurrence of NPM1,FLT3-ITD,and DNMT3A mutations(i.e.,triple mutation)is related to dismal prognosis in patients with acute myeloid leukemia(AML)receiving chemotherapy alone.In this multicenter retrospective cohort study,we aimed to identify whether allogeneic hematopoietic stem cell transplantation(allo-HSCT)could overcome the poor prognosis of DNMT3A^(mut)NPM1^(mut)FLT3-ITD^(mut)AML across four transplant centers in China.Fifty-three patients with triple-mutated AML receiving allo-HSCT in complete remission were enrolled.The 1.5-year probabilities of relapse,leukemia-free survival,and overall survival after allo-HSCT were 11.9%,80.3%,and 81.8%,respectively.Multivariate analysis revealed that more than one course of induction chemotherapy and allo-HSCT beyond CR1 were associated with poor survival.To our knowledge,this work is the largest study to explore the up-to-date undefined role of allo-HSCT in patients with triple-mutated AML.Our real-world data suggest that allo-HSCT could overcome the poor prognosis of DNMT3A^(mut)NPM1^(mut)FLT3-ITD^(mut)in AML.展开更多
基金supported by the National Key Research and Development Program of China(Nos.2022YFC2502600 and 2022YFC2502606)the National Natural Science Foundation of China(Nos.82170206 and 82170208)+3 种基金CAMS Innovation Fund for Medical Sciences(Nos.2019-I2M-5-034 and 2022-I2M-C&T-B-121)Peking University People’s Hospital Research and Development Funds(No.RZ2022-02)Tongzhou District Distinguished Young Scholars(No.JCQN2023009)Shanghai Municipal Health Commission Project of Disciplines of Excellence(No.20234Z0002)。
文摘The cooccurrence of NPM1,FLT3-ITD,and DNMT3A mutations(i.e.,triple mutation)is related to dismal prognosis in patients with acute myeloid leukemia(AML)receiving chemotherapy alone.In this multicenter retrospective cohort study,we aimed to identify whether allogeneic hematopoietic stem cell transplantation(allo-HSCT)could overcome the poor prognosis of DNMT3A^(mut)NPM1^(mut)FLT3-ITD^(mut)AML across four transplant centers in China.Fifty-three patients with triple-mutated AML receiving allo-HSCT in complete remission were enrolled.The 1.5-year probabilities of relapse,leukemia-free survival,and overall survival after allo-HSCT were 11.9%,80.3%,and 81.8%,respectively.Multivariate analysis revealed that more than one course of induction chemotherapy and allo-HSCT beyond CR1 were associated with poor survival.To our knowledge,this work is the largest study to explore the up-to-date undefined role of allo-HSCT in patients with triple-mutated AML.Our real-world data suggest that allo-HSCT could overcome the poor prognosis of DNMT3A^(mut)NPM1^(mut)FLT3-ITD^(mut)in AML.
