Adrianna Spałek, Agata Wieczorkiewicz-Kabut, Patrycja Zielińska, Anna Kopińska, Krzysztof Woźniczka, Anna Koclęga, Aleksandra Butrym, Jarosław Czyż, Grzegorz Helbig
{"title":"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。","authors":"Adrianna Spałek, Agata Wieczorkiewicz-Kabut, Patrycja Zielińska, Anna Kopińska, Krzysztof Woźniczka, Anna Koclęga, Aleksandra Butrym, Jarosław Czyż, Grzegorz Helbig","doi":"10.1080/17474086.2025.2525453","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Research design and methods: </strong>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 (<i>p=</i>0.004).</p><p><strong>Results: </strong>SORA maintenance significantly improved OS and RFS probability when compared to the control group (36.3 <i>vs</i> 11.6 months; <i>p</i> = 0.01 and 95.5% and 66.7%; <i>p</i> = 0.004; respectively). SORA maintenance effectively reduced the risk of death by 93.6% for patients in complete remission with detectable measurable residual disease (<i>p</i> = 0.001). At the last follow-up, 4.2% of patients died in SORA-group when compared with 50% in the control group (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>SORA maintenance after HSCT diminishes the cumulative incidence of relapse as well as prolongs OS and RFS in FLT3-mutated AML.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"1-8"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Post-transplant sorafenib effectively prevents relapse in FLT3-mutated acute myeloid leukemia.\",\"authors\":\"Adrianna Spałek, Agata Wieczorkiewicz-Kabut, Patrycja Zielińska, Anna Kopińska, Krzysztof Woźniczka, Anna Koclęga, Aleksandra Butrym, Jarosław Czyż, Grzegorz Helbig\",\"doi\":\"10.1080/17474086.2025.2525453\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Research design and methods: </strong>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 (<i>p=</i>0.004).</p><p><strong>Results: </strong>SORA maintenance significantly improved OS and RFS probability when compared to the control group (36.3 <i>vs</i> 11.6 months; <i>p</i> = 0.01 and 95.5% and 66.7%; <i>p</i> = 0.004; respectively). SORA maintenance effectively reduced the risk of death by 93.6% for patients in complete remission with detectable measurable residual disease (<i>p</i> = 0.001). At the last follow-up, 4.2% of patients died in SORA-group when compared with 50% in the control group (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>SORA maintenance after HSCT diminishes the cumulative incidence of relapse as well as prolongs OS and RFS in FLT3-mutated AML.</p>\",\"PeriodicalId\":12325,\"journal\":{\"name\":\"Expert Review of Hematology\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-06-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/17474086.2025.2525453\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474086.2025.2525453","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Post-transplant sorafenib effectively prevents relapse in FLT3-mutated acute myeloid leukemia.
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.
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.
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