Overall survival was also negatively influenced by concomitant FLT3-ITD (HR 1.6, p = 0.0001), MRD positivity at transplant (HR 1.61, p < 10 −5) and older age (HR 1.22, p = 0.0007), but positively affected by matched sibling donor (unrelated donor: HR 1.35, p = 0.012 haploidentical donor: HR 1.45, p = 0.037) and Karnofsky performance score ≥90 (HR 0.73, p = 0.004). In multivariate analysis, relapse incidence (RI) and leukemia-free survival (LFS) were negatively affected by concomitant FLT3-ITD mutation (HR 1.66 p = 0.0001, and HR 1.53 p = 0.00006, respectively), MRD positivity at transplant (HR 2.18 p < 10 −5 and HR 1.71 p < 10 −5, respectively), and transplant in CR2 (HR 1.36 p = 0.026, and HR 1.26 p = 0.033, respectively), but positively affected by Karnofsky performance score ≥90 (HR 0.74 p = 0.012, and HR 0.7 p = 0.0002, respectively). FLT3-ITD was present in 69.3% of patients and 39.2% had detectable minimal/measurable residual disease (MRD) at transplant. Median follow up for survivors was 23.7 months. We identified 1572 adult (age ≥ 18 years) patients with NPM1-mutated AML in first complete remission (CR1: 78%) or second complete remission (CR2: 22%) who were transplanted from matched sibling donors (30.8%), matched unrelated donors (33.7%), mismatched unrelated donors (7.6%) and haploidentical donors (11.8%) between 20 at EBMT participating centers. Methods: Here we investigated the main predictors of outcome after allogeneic hematopoietic stem cell transplantation (allo-HCT) in AML patients with NPM1 mutation. Nonetheless, the respective and independent contributions of these factors remain largely unknown. Current data suggest that the concomitant presence of FLT3-ITD and NPM1, MRD positivity before or after transplant, and disease status at the time of transplant influence the risk of post-transplant relapse and thus affect outcome. Luc, Brussels, Belgium, 13 Goethe-Universitaet, Frankfurt, Germany, 14 Hopital Brabois, CHRU Nancy, Vandoeuvre-lès-Nancy, France, 15 Charles University Hospital, Pilsen, Czech Republic, 16 Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Marseille, France, 17 University Hospital, Essen, Germany, 18 Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France, 19 Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain, 20 Chaim Cheba Medical Center, Tel Hashomer, Israel, 21 American University of Beirut, Beirut, Lebanon, 22 EBMT Paris Office, CEREST-TC, Saint Antoine Hospital, Paris, Franceīackground: Nucleophosmin-1 (NPM1) mutations in acute myeloid leukemia (AML) confer a survival advantage in the absence of FLT3-internal tandem duplication ( FLT3-ITD). Louis, Paris, France, 7 CHU de Lille, Univ Lille, INSERM U 1286, Infinite, Lille, France, 8 Gustave Roussy Cancer Campus, BMT Service, Villejuif, France, 9 University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany, 10 Manchester Royal Infirmary, Manchester, United Kingdom, 11 University Medical Center Groningen (UMCG), University of Groningen, Groningen, Netherlands, 12 Cliniques Universitaires St. ![]() Measurable Residual Disease, FLT3-ITD Mutation And Disease Status Have Independent Prognostic Influence on Post-Transplant Outcomes in NPM1-Mutated Acute Myeloid Leukemia Rama Al Hamed 1,2, Myriam Labopin 2, Eric Deconinck 3, Riitta Niittyvuopio 4, Anne Huynh 5, Gerard Socié 6, Ibrahim Yakoub-Agha 7, Jean Henri Bourhis 8, Hassan Naim 9, Eleni Tholouli 10, Goda Choi 11, Xavier Poiré 12, Hans Martin 13, Marie-Thérèse Rubio 14, Pavel Jindra 15, Didier Blaise 16, Dietrich Beelen 17, Hélène Labussière-Wallet 18, Jordi Esteve 19, Arnon Nagler 20, Ali Bazarbachi 21, Mohamad Mohty 22 1 Jacobi Medical Center-Albert Einstein College of Medicine, The Bronx, United States, 2 EBMT Paris Office, CEREST-TC, Saint Antoine Hospital, Paris, France, 3 Hôpital Jean Minjoz, Service d`Hématologie, Besacon, France, 4 HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland, 5 CHU IUCT-O, Toulouse, France, 6 Hôpital St.
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