The prognostic value of KIT mutations and the optimal thresholds and time points for MRD monitoring in acute myelogenous leukemia (AML) are controversial. Patients with high-risk disease features may benefit from stem cell transplantation, but determining the relative benefits of autologous versus allogeneic stem cell transplantation (SCT) is difficult due to limited data about major risk factors such as KIT mutations and MRD status.
A retrospective study by researchers at the Catholic University of Korea, published in June in Bone Marrow Transplantation, has shown that the D816V KIT mutation is significantly associated with post-transplant relapse in AML patients with a CBFB-MYH11 rearrangement mutation. The same research group showed in a previous retrospective study that the same KIT mutation was significantly associated with post-transplant relapse and poor survival in AML patients with a RUNX1-RUNX1T1 mutation.
In the current study, retrospective evaluation of 88 patients following either autologous or allogeneic SCT found that both the D816V KIT mutation and CBFB-MYH11 MRD assessments were independently associated with post-transplant relapse and survival. Autologous SCT was superior in MRD-negative patients without the D816V KIT mutation, whereas allogeneic SCT tended to be superior in patients who were MRD positive or had the D816V KIT mutation.
This finding mirrored that of the group’s prior study, published in January in Cancers, in which 166 high-risk patients undergoing SCT were retrospectively evaluated. In this earlier report, the researchers concluded that “risk stratification by both D816V KIT mutation and RUNX1-RUNX1T1 MRD status could provide a platform for decision-making or risk-adapted therapeutic approaches.”
- Cho BS, Min GJ, Park SS, et al. Prognostic values of D816V KIT mutation and peri-transplant CBFB-MYH11 MRD monitoring on acute myeloid leukemia with CBFB-MYH11. Bone Marrow Transplant. 2021. https://doi.org/10.1038/s41409-021-01384-w [published online ahead of print]
- Cho BS, Min GJ, Park SS, et al. Prognostic Impacts of D816V KIT Mutation and Peri-Transplant RUNX1-RUNX1T1 MRD Monitoring on Acute Myeloid Leukemia with RUNX1-RUNX1T1. Cancers (Basel). 2021;13(2):336. doi:10.3390/cancers13020336