Fiche publication
Date publication
octobre 2026
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Dr SIMAND Célestine
Tous les auteurs :
Leclerc M, Audureau E, Duployez N, Hunault M, Tavernier E, Pautas C, Bertoli S, Raffoux E, Hospital MA, Marchand T, Heiblig M, Chantepie S, Carre M, Peterlin P, Gallego-Hernanz MP, Guieze R, Simand C, Turlure P, Huynh A, Lemasle E, Gabellier L, Lambert J, Suarez F, Chraibi S, Sanhes L, Celli-Lebras K, Mineur A, Gardin C, Malfuson JV, Cluzeau T, Vey N, Latour RP, Rigolot L, Luquet I, Penther D, Itzykson R, Delabesse E, Hamel JF, Botton S, Pigneux A, Dombret H, Preudhomme C, Recher C, Dumas PY
Lien Pubmed
Résumé
The prognostic value of FLT3 internal tandem duplication (FLT3-ITD) in acute myeloid leukemia (AML) has traditionally been stratified according to the ITD/wild-type allelic ratio (AR) and NPM1 co-mutation status. We evaluated the prognostic impact of FLT3-ITD AR in 459 newly diagnosed AML patients younger than 60 years enrolled in the prospective BIG-1 study, all treated with high-dose anthracycline-based induction. From 2018 onward, midostaurin was added for FLT3-mutated cases. AR was not associated with composite complete remission (81.7% vs. 79.6% in low vs. high AR, p = 0.85), overall survival (OS) (median 7.6 vs. 6.9 years, p = 0.25), relapse-free survival (median 2.0 vs. 1.7 years, p = 0.50), or event-free survival (median 1.4 vs. 1.2 years, p = 0.58). In multivariable analyses, only midostaurin exposure (adjusted hazard ratio [aHR] 0.69, 95% CI 0.50-0.95, p = 0.024) and adverse ELN-2022 risk (aHR 1.66, 95% CI 1.18-2.34, p = 0.004) were independently associated with OS. Allogeneic hematopoietic stem cell transplantation was associated with improved relapse-free (aHR 0.40, 95% CI 0.29-0.55, p < 0.001) and event-free survival (aHR 0.37, 95% CI 0.27-0.51, p < 0.001), but not OS. These results indicate that FLT3-ITD AR has no independent prognostic impact in younger AML patients treated with intensive anthracycline-based chemotherapy and midostaurin in contemporary clinical practice.
Référence
Am J Hematol. 2026 10 26;:
