Venetoclax and hypomethylating agents in FLT3-mutated acute myeloid leukemia.
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
revised:
24
06
2020
received:
18
05
2020
accepted:
02
07
2020
medline:
7
7
2020
pubmed:
7
7
2020
entrez:
7
7
2020
Statut:
ppublish
Résumé
FMS-like tyrosine kinase 3 (FLT3) mutations are prevalent in acute myeloid leukemia (AML), and their presence confers adverse risk. FLT3-mutated (FLT3m) AML is a challenging leukemia to manage, particularly in older and unfit patients as well as patients with relapsed/refractory (r/r) disease. We retrospectively analyzed the outcomes of 50 FLT3m AML patients (17 treatment-naïve, 33 r/r) treated with venetoclax (VEN) and hypomethylating agents (HMA). The overall CR/CRi rate with VEN-HMA was 60% (94% in treatment-naïve AML and 42% in r/r AML). Early (60-days) treatment related mortality was 2%. The r/r AML setting was an independent predictor of lower complete response (OR: 0.08; 95%CI: 0.00-0.60, P = .03). Cytogenetics-molecular risk, concurrent mutations, the type of FLT3 mutation (ITD vs TKD), the ITD allelic ratio, the type of HMA, age, prior exposure to HMA and receipt of prior allogeneic transplant did not independently impact response or leukemia-free survival (LFS). Concurrent IDH mutations were associated with lower CR/CRi (P = .01), while ASXL1 or TET2 mutations showed a non-significant association toward higher CR/CRi (P = .07, for both). However, none of the concurrent mutations were an independent predictor for response when adjusted to AML setting. In conclusion, VEN-HMA is associated with encouraging efficacy in FLT3m AML among both newly diagnosed unfit and r/r patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1193-1199Subventions
Organisme : NCI NIH HHS
ID : P30 CA033572
Pays : United States
Organisme : NIH HHS
Pays : United States
Organisme : NIH HHS
Pays : United States
Organisme : NIH HHS
Pays : United States
Organisme : NCI NIH HHS
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals LLC.
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