Characteristics of NPM1/FLT3-ITD molecular subgroups among 702 patients undergoing allogeneic HSCT in first CR for AML with normal cytogenetics, as of molecular subgroups
| . | Total (n = 702) . | NPM1wt/FLT3wt (n = 290) . | NPM1mut/FLT3wt (n = 68) . | NPM1wt/ FLT3-ITD (n = 75) . | NPM1mut/ FLT3-ITD (n = 269) . | P . |
|---|---|---|---|---|---|---|
| Age (y), median (range) | 51 (18-71) | 52 (21-70) | 52 (24-67) | 47 (19-70) | 51 (18-71) | .05 |
| Interval diagnosis to CR1 (days), median (range) | 43 (10-210) | 47 | 38 | 48 | 39 | <.001 |
| Interval CR1 to HSCT (days), median (range) | 106 (11-643) | 110 | 107 | 98 | 104 | .5 |
| Interval diag to HSCT (days), median (range) | 155 (55-714) | 162 | 160 | 153 | 149 | .02 |
| Year of HSCT, median | 2010 | 2009 | 2009 | 2010 | 2010 | <.001 |
| Patient sex, n (%) | ||||||
| Male | 357 (51%) | 162 (56%) | 30 (44%) | 41 (55%) | 124 (46%) | .07 |
| Female | 345 (49%) | 128 (44%) | 38 (56%) | 34 (45%) | 145 (54%) | |
| Donor sex , n (%) | ||||||
| Male | 419 (60%) | 182 (63%) | 42 (63%) | 42 (56%) | 153 (57%) | .49 |
| Female | 280 (40%) | 108 (37%) | 25 (37%) | 33 (44%) | 114 (43%) | |
| Female donor for male patient, n (%) | ||||||
| No | 577 (83%) | 235 (81%) | 58 (87%) | 58 (77%) | 226 (85%) | .33 |
| Yes | 122 (18%) | 55 (19%) | 9 (13%) | 17 (23%) | 41 (15%) | |
| Donor type, n (%) | ||||||
| HLA id sibling | 383 (55%) | 163 (56%) | 38 (56%) | 38 (51%) | 144 (54%) | .82* |
| UD | 319 (45%) | 127 (44%) | 30 (44%) | 37 (49%) | 125 (47%) | |
| 10/10 AG match | 225 | 93 | 19 | 25 | 88 | .51† |
| 9/10 AG match | 49 | 21 | 7 | 6 | 15 | |
| 8/8 AG match | 45 | 13 | 4 | 6 | 22 | |
| Conditioning, n (%) | ||||||
| Myeloablative | 330 (47%) | 116 (40%) | 31 (46%) | 43 (57%) | 140 (52%) | .007 |
| BuCy | 162 | 67 | 15 | 16 | 64 | |
| BuFlu | 41 | 11 | 1 | 6 | 23 | |
| CyTBI | 88 | 27 | 7 | 14 | 40 | |
| Other | 39 | 11 | 8 | 7 | 13 | |
| Reduced, n (%) | 370 (53%) | 174 (60%) | 37 (54%) | 32 (43%) | 127 (48%) | |
| BuFlu | 192 | 90 | 16 | 13 | 73 | |
| FluMel | 55 | 18 | 8 | 5 | 24 | |
| Other | 123 | 66 | 13 | 14 | 30 | |
| CMV serostatus (donor/patient), n (%) | ||||||
| neg/neg | 193 (28%) | 80 (28%) | 19 (29%) | 25 (33%) | 68 (25%) | .86 (.06 for neg/neg vs other) |
| pos/neg | 71 (10%) | 33 (11%) | 5 (8%) | 8 (11%) | 24 (9%) | |
| neg/pos | 170 (24%) | 67 (23%) | 14 (21%) | 16 (21%) | 72 (27%) | |
| pos/pos | 268 (38%) | 110 (38%) | 28 (42%) | 26 (35%) | 103 (39%) | |
| Stem cell source, n (%) | ||||||
| BM | 159 (23%) | 62 (21%) | 18 (27%) | 15 (20%) | 64 (24%) | .72 |
| PB | 543 (77%) | 228 (79%) | 50 (74%) | 60 (80%) | 205 (76%) | |
| Number of induction courses to reach CR1, n (%) | ||||||
| 1 | 486 (75%) | 200 (75%) | 47 (73%) | 35 (52%) | 204 (81%) | <.001 |
| ≥2 | 163 (25%) | 66 (25%) | 17 (27%) | 33 (49%) | 47 (19%) | |
| Total number of chemotherapy courses before HSCT, n (%) | ||||||
| 1 | 83 (29%) | 38 (29%) | 11 (29%) | 8 (28%) | 26 (32%) | .27 |
| 2 | 112 (40%) | 56 (42%) | 18 (47%) | 12 (41%) | 26 (32%) | |
| 3 | 62 (22%) | 33 (25%) | 4 (11%) | 5 (17%) | 20 (24%) | |
| >3 | 25 (9%) | 6 (5%) | 5 (13%) | 4 (14%) | 10 (12%) | |
| Use of ATG, n (%) | ||||||
| No | 387 (55%) | 156 (54%) | 36 (53%) | 43 (58%) | 152 (57%) | .85 |
| Yes | 312 (45%) | 133 (46%) | 32 (47%) | 31 (42%) | 116 (43%) | |
| HLA id sibling, n (%) | ||||||
| No ATG | 268 (71%) | 111 (69%) | 24 (63%) | 26 (70%) | 107 (75%) | .46 |
| ATG | 112 (29%) | 51 (31%) | 14 (37%) | 11 (30%) | 36 (25%) | |
| URD, n (%) | ||||||
| No ATG | 119 (37%) | 45 (35%) | 12 (40%) | 17 (46%) | 45 (36%) | .67 |
| ATG | 200 (63%) | 82 (65%) | 18 (60%) | 20 (54%) | 80 (64%) | |
| GVHD prophylaxis, n (%) | ||||||
| CyA-based | 635 (91%) | 266 (92%) | 61 (90%) | 67 (92%) | 241 (90%) | .43 |
| CyA+MTX | 322 | 123 | 33 | 33 | 133 | |
| CyA+MMF | 187 | 92 | 13 | 26 | 56 | |
| CyA+other | 126 | 51 | 15 | 8 | 52 | |
| Tacrolimus-based | 37 (5%) | 16 (6%) | 2 (3%) | 4 (5%) | 15 (6%) | |
| Tacrolimus+MMF | 21 | 14 | 2 | 1 | 4 | |
| Tacrolimus+other | 16 | 2 | — | 3 | 9 | |
| Other | 30 | 8 | 5 | 4 | 13 | |
| 3% | 2% | 7% | 3% | 4% | ||
| Acute GVHD after HSCT, n (%) | ||||||
| AGVH <II | 498 (74%) | 199 (72%) | 56 (85%) | 52 (70%) | 191 (73%) | .16 |
| AGVH ≥II | 180 (27%) | 78 (28%) | 10 (15%) | 22 (30%) | 70 (27%) |
| . | Total (n = 702) . | NPM1wt/FLT3wt (n = 290) . | NPM1mut/FLT3wt (n = 68) . | NPM1wt/ FLT3-ITD (n = 75) . | NPM1mut/ FLT3-ITD (n = 269) . | P . |
|---|---|---|---|---|---|---|
| Age (y), median (range) | 51 (18-71) | 52 (21-70) | 52 (24-67) | 47 (19-70) | 51 (18-71) | .05 |
| Interval diagnosis to CR1 (days), median (range) | 43 (10-210) | 47 | 38 | 48 | 39 | <.001 |
| Interval CR1 to HSCT (days), median (range) | 106 (11-643) | 110 | 107 | 98 | 104 | .5 |
| Interval diag to HSCT (days), median (range) | 155 (55-714) | 162 | 160 | 153 | 149 | .02 |
| Year of HSCT, median | 2010 | 2009 | 2009 | 2010 | 2010 | <.001 |
| Patient sex, n (%) | ||||||
| Male | 357 (51%) | 162 (56%) | 30 (44%) | 41 (55%) | 124 (46%) | .07 |
| Female | 345 (49%) | 128 (44%) | 38 (56%) | 34 (45%) | 145 (54%) | |
| Donor sex , n (%) | ||||||
| Male | 419 (60%) | 182 (63%) | 42 (63%) | 42 (56%) | 153 (57%) | .49 |
| Female | 280 (40%) | 108 (37%) | 25 (37%) | 33 (44%) | 114 (43%) | |
| Female donor for male patient, n (%) | ||||||
| No | 577 (83%) | 235 (81%) | 58 (87%) | 58 (77%) | 226 (85%) | .33 |
| Yes | 122 (18%) | 55 (19%) | 9 (13%) | 17 (23%) | 41 (15%) | |
| Donor type, n (%) | ||||||
| HLA id sibling | 383 (55%) | 163 (56%) | 38 (56%) | 38 (51%) | 144 (54%) | .82* |
| UD | 319 (45%) | 127 (44%) | 30 (44%) | 37 (49%) | 125 (47%) | |
| 10/10 AG match | 225 | 93 | 19 | 25 | 88 | .51† |
| 9/10 AG match | 49 | 21 | 7 | 6 | 15 | |
| 8/8 AG match | 45 | 13 | 4 | 6 | 22 | |
| Conditioning, n (%) | ||||||
| Myeloablative | 330 (47%) | 116 (40%) | 31 (46%) | 43 (57%) | 140 (52%) | .007 |
| BuCy | 162 | 67 | 15 | 16 | 64 | |
| BuFlu | 41 | 11 | 1 | 6 | 23 | |
| CyTBI | 88 | 27 | 7 | 14 | 40 | |
| Other | 39 | 11 | 8 | 7 | 13 | |
| Reduced, n (%) | 370 (53%) | 174 (60%) | 37 (54%) | 32 (43%) | 127 (48%) | |
| BuFlu | 192 | 90 | 16 | 13 | 73 | |
| FluMel | 55 | 18 | 8 | 5 | 24 | |
| Other | 123 | 66 | 13 | 14 | 30 | |
| CMV serostatus (donor/patient), n (%) | ||||||
| neg/neg | 193 (28%) | 80 (28%) | 19 (29%) | 25 (33%) | 68 (25%) | .86 (.06 for neg/neg vs other) |
| pos/neg | 71 (10%) | 33 (11%) | 5 (8%) | 8 (11%) | 24 (9%) | |
| neg/pos | 170 (24%) | 67 (23%) | 14 (21%) | 16 (21%) | 72 (27%) | |
| pos/pos | 268 (38%) | 110 (38%) | 28 (42%) | 26 (35%) | 103 (39%) | |
| Stem cell source, n (%) | ||||||
| BM | 159 (23%) | 62 (21%) | 18 (27%) | 15 (20%) | 64 (24%) | .72 |
| PB | 543 (77%) | 228 (79%) | 50 (74%) | 60 (80%) | 205 (76%) | |
| Number of induction courses to reach CR1, n (%) | ||||||
| 1 | 486 (75%) | 200 (75%) | 47 (73%) | 35 (52%) | 204 (81%) | <.001 |
| ≥2 | 163 (25%) | 66 (25%) | 17 (27%) | 33 (49%) | 47 (19%) | |
| Total number of chemotherapy courses before HSCT, n (%) | ||||||
| 1 | 83 (29%) | 38 (29%) | 11 (29%) | 8 (28%) | 26 (32%) | .27 |
| 2 | 112 (40%) | 56 (42%) | 18 (47%) | 12 (41%) | 26 (32%) | |
| 3 | 62 (22%) | 33 (25%) | 4 (11%) | 5 (17%) | 20 (24%) | |
| >3 | 25 (9%) | 6 (5%) | 5 (13%) | 4 (14%) | 10 (12%) | |
| Use of ATG, n (%) | ||||||
| No | 387 (55%) | 156 (54%) | 36 (53%) | 43 (58%) | 152 (57%) | .85 |
| Yes | 312 (45%) | 133 (46%) | 32 (47%) | 31 (42%) | 116 (43%) | |
| HLA id sibling, n (%) | ||||||
| No ATG | 268 (71%) | 111 (69%) | 24 (63%) | 26 (70%) | 107 (75%) | .46 |
| ATG | 112 (29%) | 51 (31%) | 14 (37%) | 11 (30%) | 36 (25%) | |
| URD, n (%) | ||||||
| No ATG | 119 (37%) | 45 (35%) | 12 (40%) | 17 (46%) | 45 (36%) | .67 |
| ATG | 200 (63%) | 82 (65%) | 18 (60%) | 20 (54%) | 80 (64%) | |
| GVHD prophylaxis, n (%) | ||||||
| CyA-based | 635 (91%) | 266 (92%) | 61 (90%) | 67 (92%) | 241 (90%) | .43 |
| CyA+MTX | 322 | 123 | 33 | 33 | 133 | |
| CyA+MMF | 187 | 92 | 13 | 26 | 56 | |
| CyA+other | 126 | 51 | 15 | 8 | 52 | |
| Tacrolimus-based | 37 (5%) | 16 (6%) | 2 (3%) | 4 (5%) | 15 (6%) | |
| Tacrolimus+MMF | 21 | 14 | 2 | 1 | 4 | |
| Tacrolimus+other | 16 | 2 | — | 3 | 9 | |
| Other | 30 | 8 | 5 | 4 | 13 | |
| 3% | 2% | 7% | 3% | 4% | ||
| Acute GVHD after HSCT, n (%) | ||||||
| AGVH <II | 498 (74%) | 199 (72%) | 56 (85%) | 52 (70%) | 191 (73%) | .16 |
| AGVH ≥II | 180 (27%) | 78 (28%) | 10 (15%) | 22 (30%) | 70 (27%) |
ATG, antithymocyte globulin; BuCy, busulfan/cyclophosphamide; BuFlu, busulfan/fludarabin; CR1, first complete remission; CyA, cyclosporin A; CyTBI, cyclophosphamide/total body irradiation; FluMel, fludarabin/melphalan; MMF, mycophenolate mofetil; MTX, methotrexate; UD, unrelated donor.
HLA identical sibling vs unrelated donors.
Different subgroups of unrelated donors (10/0 vs 9/10 vs 8/8 AG match).