Efficacy and Feasibility of Sorafenib as a Maintenance Agent After Allogeneic Hematopoietic Stem Cell Transplantation for Fms-like Tyrosine Kinase 3 Mutated Acute Myeloid Leukemia: An Update

Abstract

Background: Patients diagnosed with acute myeloid leukemia (AML) with Fms-like tyrosine kinase 3 (FLT3) mutations have a very poor prognosis, despite use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and salvage treatments. Patients and Methods: We previously reported the safety and efficacy of sorafenib, an FLT3 inhibitor, as a maintenance agent after allo-HSCT in patients diagnosed with AML with FLT3 mutations. We provide an update on the 27 patients with FLT3-mutated AML in our original report, who received sorafenib as a single maintenance agent. Results: Since our previous report, others have confirmed our reported significant overall survival and progression-free survival in patients who received sorafenib before and/or after allo-HSCT. In this update on the 27 patients with FLT3-mutated AML in our original report, we show persistence of the previously reported impressive long-term disease control. Conclusion: Our results, with longer follow-up than in our previous report, together with those of others, further support the use of sorafenib as a maintenance agent after allo-HSCT. Patients with acute myeloid leukemia (AML) with Fms-like tyrosine kinase 3 (FLT3) mutations have a very poor prognosis, despite use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and salvage treatments. We previously reported the safety and efficacy of sorafenib, as a maintenance agent after allo-HSCT in 27 patients with FLT3-mutated AML. We provide an update on the patients in our original report, who received sorafenib as a single maintenance agent, and show persistence of the previously reported impressive long-term disease control. Our results continue to support the use of sorafenib as a maintenance agent after allo-HSCT. © 2019 Elsevier Inc.

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Allogeneic stem cell transplantation, Flt3 mutated acute myeloid leukemia, Maintenance treatment, Sorafenib, Update, Adolescent, Adult, Cohort studies, Combined modality therapy, Feasibility studies, Female, Fms-like tyrosine kinase 3, Follow-up studies, Hematopoietic stem cell transplantation, Humans, Leukemia, myeloid, acute, Maintenance chemotherapy, Male, Middle aged, Mutation, Prognosis, Protein kinase inhibitors, Remission induction, Survival rate, Transplantation, homologous, Young adult, Azacitidine, Cd135 antigen, Flt3 protein, human, Protein kinase inhibitor, Acute myeloid leukemia, Allogeneic hematopoietic stem cell transplantation, Article, Cancer survival, Chronic graft versus host disease, Clinical article, Controlled study, Disease control, Drug dose reduction, Drug efficacy, Drug safety, Drug withdrawal, Feasibility study, Follow up, Human, Long term care, Maintenance therapy, Overall survival, Progression free survival, Allotransplantation, Cohort analysis, Genetics, Mortality, Multimodality cancer therapy, Pathology, Remission

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