Post-transplant sorafenib effectively prevents relapse in FLT3-mutated acute myeloid leukemia.

IF 2.1 4区医学 Q2 HEMATOLOGY

Expert Review of Hematology Pub Date : 2025-06-27 DOI:10.1080/17474086.2025.2525453

Adrianna Spałek, Agata Wieczorkiewicz-Kabut, Patrycja Zielińska, Anna Kopińska, Krzysztof Woźniczka, Anna Koclęga, Aleksandra Butrym, Jarosław Czyż, Grzegorz Helbig

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Abstract

Background: Almost 50% of patients with FLT3-ITD AML relapse despite undergoing allogeneic hematopoietic stem cell transplantation (HSCT). FLT-3 inhibitors (FLT3i) can be used in a post-HSCT setting as a relapse prevention.

Research design and methods: We retrospectively compared 24 FLT3-mutated AML patients receiving post-HSCT SORA with a control group of 24 FLT3-mutated AML SORA-free individuals. SORA was initiated at a median of 2.9 months after transplantation. Median dosage was 600 mg daily with median treatment duration of 8.8 months. Due to toxicities, 16/24 patients required dose modifications with 6 early SORA withdrawals. After median follow-up of 20.7 months, 1 patient relapsed in SORA-group whereas 9 relapses were observed in the control group (p=0.004).

Results: SORA maintenance significantly improved OS and RFS probability when compared to the control group (36.3 vs 11.6 months; p = 0.01 and 95.5% and 66.7%; p = 0.004; respectively). SORA maintenance effectively reduced the risk of death by 93.6% for patients in complete remission with detectable measurable residual disease (p = 0.001). At the last follow-up, 4.2% of patients died in SORA-group when compared with 50% in the control group (p < 0.001).

Conclusions: SORA maintenance after HSCT diminishes the cumulative incidence of relapse as well as prolongs OS and RFS in FLT3-mutated AML.

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移植后索拉非尼可有效预防flt3突变的急性髓系白血病复发。

背景：近50%的FLT3-ITD AML患者尽管接受了同种异体造血干细胞移植（HSCT），但仍会复发。FLT-3抑制剂（FLT3i）可用于hsct后的复发预防。研究设计和方法：我们回顾性比较了24例接受hsct后SORA治疗的flt3突变AML患者和24例不接受SORA治疗的flt3突变AML患者。SORA在移植后2.9个月开始。中位剂量为每日600毫克，中位治疗持续时间为8.8个月。由于毒性，24例患者中有16例需要调整剂量，其中6例早期停药。中位随访20.7个月后，sora组复发1例，对照组复发9例（p=0.004）。结果：与对照组相比，SORA维持显著提高了OS和RFS概率(36.3个月vs 11.6个月；P = 0.01、95.5%、66.7%；p = 0.004；分别)。SORA维持有效地将完全缓解且可检测到可测量残余疾病的患者的死亡风险降低了93.6% （p = 0.001）。在最后一次随访中，SORA组的患者死亡率为4.2%，而对照组为50% (p)。结论：HSCT后SORA维持降低了flt3突变AML的累积复发发生率，并延长了OS和RFS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.