Long-term survival of sorafenib-treated FLT3-ITD–positive acute myeloid leukaemia patients relapsing after allogeneic stem cell transplantation

Publication date: November 2017
Source:European Journal of Cancer, Volume 86
Author(s): S.K. Metzelder, T. Schroeder, M. Lübbert, M. Ditschkowski, K. Götze, S. Scholl, R.G. Meyer, P. Dreger, N. Basara, M.F. Fey, H.R. Salih, A. Finck, T. Pabst, A. Giagounidis, G. Kobbe, E. Wollmer, J. Finke, A. Neubauer, A. Burchert
BackgroundFms-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD)–positive acute myeloid leukaemia (AML) relapsing after allogeneic stem cell transplantation (allo-SCT) has a dismal prognosis with limited therapeutic options. FLT3-ITD kinase inhibition is a reasonable but palliative experimental treatment alternative in this situation. Information on long-term outcome is not available.MethodsWe performed a long-term follow-up analysis of a previously reported cohort of 29 FLT3-ITD–positive AML patients, which were treated in relapse after allo-SCT with sorafenib monotherapy.FindingsWith a median follow-up of 7.5 years, 6 of 29 patients (21%) are still alive. Excluding one patient who received a second allo-SCT, five patients (17%) achieved sustained complete remissions with sorafenib. Four of these patients are in treatment-free remission for a median of 4.4 years.InterpretationSorafenib may enable cure of a proportion of very poor risk FLT3-ITD–positive AML relapsing after allo-SCT.



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