Clinical practice recommendation on hematopoietic stem cell transplantation for acute myeloid leukemia patients with FLT3internal tandem duplication: A position statement from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

A. Bazarbachi, G. Bug, F. Baron, E. Brissot, F. Ciceri, I.A. Dalle, H. Döhner, J. Esteve, Y. Floisand, S. Giebel, M. Gilleece, N.-C. Gorin, E. Jabbour, M. Aljurf, H. Kantarjian, M. Kharfan-Dabaja, M. Labopin, F. Lanza, F. Malard, Z. PericT. Prebet, F. Ravandi, A. Ruggeri, J. Sanz, C. Schmid, R. Shouval, A. Spyridonidis, J. Versluis, N. Vey, B.N. Savani, A. Nagler, M. Mohty

Research output: Contribution to journalArticlepeer-review

Abstract

The FMS-like tyrosine kinase 3 (FLT3) gene is mutated in 25-30% of patients with acute myeloid leukemia (AML). Because of the poor prognosis associated with FLT3-internal tandem duplication mutated AML, allogeneic hematopoietic stem-cell transplantation (SCT) was commonly performed in first complete remission. Remarkable progress has been made in frontline treatments with the incorporation of FLT3 inhibitors and the development of highly sensitive minimal/measurable residual disease assays. Similarly, recent progress in allogeneic hematopoietic SCT includes improvement of transplant techniques, the use of haplo-identical donors in patients lacking an HLA matched donor, and the introduction of FLT3 inhibitors as post-transplant maintenance therapy. Nevertheless, current transplant strategies vary between centers and differ in terms of transplant indications based on the internal tandem duplication allelic ratio and concomitant nucleophosmin-1 mutation, as well as in terms of post-transplant maintenance/consolidation. This review generated by international leukemia or transplant experts, mostly from the European Society for Blood and Marrow Transplantation, attempts to develop a position statement on best approaches for allogeneic hematopoietic SCT for AML with FLT3-internal tandem duplication including indications for and modalities of such transplants and on the potential optimization of post-transplant maintenance with FLT inhibitors. © 2020 Ferrata Storti Foundation
Original languageEnglish
Pages (from-to)1507-1516
Number of pages10
JournalHaematologica
Volume105
Issue number6
DOIs
Publication statusPublished - 2020

Keywords

  • CD135 antigen
  • acute myeloid leukemia
  • allogeneic hematopoietic stem cell transplantation
  • cancer prognosis
  • cardiac patient
  • chromosome duplication
  • clinical outcome
  • consensus
  • hematopoietic stem cell transplantation
  • human
  • internal tandem duplication
  • maintenance therapy
  • medical society
  • multicenter study (topic)
  • phase 3 clinical trial (topic)
  • practice guideline
  • predictive value
  • randomized controlled trial (topic)
  • Review
  • treatment indication

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