Objective: To study the clinical outcome of patients with fms-like tyrosine kinase-3 internal tandem duplication (FLT3-ITD) positive acute myeloid leukemia (AML) treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore the potential prognostic factors to patients' survival including transplant types or disease status.
Methods: A total of 314 AML patients in our center from October 2006 to October 2012 were retrospectively analyzed, among whom, 54 patients were defined with FLT3-ITD positive. Survival rates and treatment-related mortality were further analyzed.
Results: For all 54 FLT3-ITD positive patients, the 3-year overall survival (3-OS) rate was 56% and 3-year leukemia-free survival (3-LFS) rate was 47%. The outcome of haplo-identical HSCT was similar as that of sibling donors (3-OS rate: 60% vs 54%; 3-LFS rate: 54% vs 45%, respectively) . There were 47 patients who received transplantation in first complete remission (CR1) . The other 7 patients were of disease relapse or in CR2 before transplantation. Not surprisingly, patients in CR1 had better prognosis than those in non-CR1.
Conclusions: Allo-HSCT is an effective treatment for AML patients with FLT3-ITD positive mutation. The survival outcome of haplo-identical HSCT was comparable with that of sibling donors. Relapse of AML was the dominant factor related to the mortality of FLT3-ITD positive AML patients after allo-HSCT.