Zhonghui Jiang, Ya Zhou, Yuxin Bai, Fang Dai, Menglin Fan, Tian Zhang, Danian Nie, Yunxin Zeng, Yirong Jiang, Ping Zhu, Zhiping Fan, Na Xu, Fen Huang, Ren Lin, Min Dai, Xiaojun Xu, Zhangkun Li, Hua Jin, Jing Sun, Qifa Liu, Li Xuan
{"title":"含有索拉非尼和供体淋巴细胞输注的补救性治疗与同种异体造血干细胞移植后FLT3野生型急性髓性白血病复发的改善结果相关。","authors":"Zhonghui Jiang, Ya Zhou, Yuxin Bai, Fang Dai, Menglin Fan, Tian Zhang, Danian Nie, Yunxin Zeng, Yirong Jiang, Ping Zhu, Zhiping Fan, Na Xu, Fen Huang, Ren Lin, Min Dai, Xiaojun Xu, Zhangkun Li, Hua Jin, Jing Sun, Qifa Liu, Li Xuan","doi":"10.1186/s40364-025-00816-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is no established standard treatment for acute myeloid leukemia (AML) patients with FLT3 wild-type relapsing after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Multi-kinase inhibitor sorafenib has been widely explored in the treatment of AML patients with FLT3 internal tandem duplication (FLT3-ITD) mutations. Some studies have revealed that the addition of sorafenib to standard chemotherapy could improve outcomes in newly diagnosed AML regardless of FLT3 status. However, the application of sorafenib in FLT3 wild-type AML patients experiencing relapse after allo-HSCT remains minimally investigated.</p><p><strong>Methods: </strong>We retrospectively compared the effects of conventional treatment combined with or without sorafenib on the outcomes of these patients. The study mainly focused on the treatment response of salvage therapy and survival.</p><p><strong>Results: </strong>Sixty-two AML patients with FLT3 wild-type who relapsed after allo-HSCT were enrolled in this study, including 38 with sorafenib and 24 without sorafenib. Fifty patients received 68 doses of donor lymphocyte infusion (DLI). The rate of composite complete remission was 65.8% in the sorafenib group, compared with 29.2% in the non-sorafenib group (P = 0.005). With a median follow-up of 13.2 months (IQR, 3.2-43.5) after relapse, the 2-year overall survival (OS) was 47.4% (95%CI, 33.9%-66.2%) and 16.7% (6.8%-40.8%) in the sorafenib and non-sorafenib groups (P = 0.006). The 2-year event-free survival (EFS) was 44.7% (31.4%-63.7%) and 16.7% (6.8%-40.8%) in the two groups (P = 0.012). Multivariable analysis revealed that salvage therapy including sorafenib was the protective factor for longer OS and EFS (HR = 0.395, 95% CI: 0.209-0.746, P = 0.004; HR = 0.406, 95% CI: 0.218-0.754, P = 0.004). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were similar between the two groups (P = 0.806, P = 0.908).</p><p><strong>Conclusion: </strong>Our results suggest that salvage therapy including sorafenib and DLI is associated with improved outcomes for AML patients with FLT3 wild-type relapsing after allo-HSCT.</p>","PeriodicalId":54225,"journal":{"name":"Biomarker Research","volume":"13 1","pages":"106"},"PeriodicalIF":11.5000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366021/pdf/","citationCount":"0","resultStr":"{\"title\":\"Salvage therapy containing sorafenib and donor lymphocyte infusion is associated with improved outcomes for FLT3 wild-type acute myeloid leukemia relapsing after allogeneic hematopoietic stem cell transplantation.\",\"authors\":\"Zhonghui Jiang, Ya Zhou, Yuxin Bai, Fang Dai, Menglin Fan, Tian Zhang, Danian Nie, Yunxin Zeng, Yirong Jiang, Ping Zhu, Zhiping Fan, Na Xu, Fen Huang, Ren Lin, Min Dai, Xiaojun Xu, Zhangkun Li, Hua Jin, Jing Sun, Qifa Liu, Li Xuan\",\"doi\":\"10.1186/s40364-025-00816-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There is no established standard treatment for acute myeloid leukemia (AML) patients with FLT3 wild-type relapsing after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Multi-kinase inhibitor sorafenib has been widely explored in the treatment of AML patients with FLT3 internal tandem duplication (FLT3-ITD) mutations. Some studies have revealed that the addition of sorafenib to standard chemotherapy could improve outcomes in newly diagnosed AML regardless of FLT3 status. However, the application of sorafenib in FLT3 wild-type AML patients experiencing relapse after allo-HSCT remains minimally investigated.</p><p><strong>Methods: </strong>We retrospectively compared the effects of conventional treatment combined with or without sorafenib on the outcomes of these patients. The study mainly focused on the treatment response of salvage therapy and survival.</p><p><strong>Results: </strong>Sixty-two AML patients with FLT3 wild-type who relapsed after allo-HSCT were enrolled in this study, including 38 with sorafenib and 24 without sorafenib. Fifty patients received 68 doses of donor lymphocyte infusion (DLI). The rate of composite complete remission was 65.8% in the sorafenib group, compared with 29.2% in the non-sorafenib group (P = 0.005). With a median follow-up of 13.2 months (IQR, 3.2-43.5) after relapse, the 2-year overall survival (OS) was 47.4% (95%CI, 33.9%-66.2%) and 16.7% (6.8%-40.8%) in the sorafenib and non-sorafenib groups (P = 0.006). The 2-year event-free survival (EFS) was 44.7% (31.4%-63.7%) and 16.7% (6.8%-40.8%) in the two groups (P = 0.012). Multivariable analysis revealed that salvage therapy including sorafenib was the protective factor for longer OS and EFS (HR = 0.395, 95% CI: 0.209-0.746, P = 0.004; HR = 0.406, 95% CI: 0.218-0.754, P = 0.004). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were similar between the two groups (P = 0.806, P = 0.908).</p><p><strong>Conclusion: </strong>Our results suggest that salvage therapy including sorafenib and DLI is associated with improved outcomes for AML patients with FLT3 wild-type relapsing after allo-HSCT.</p>\",\"PeriodicalId\":54225,\"journal\":{\"name\":\"Biomarker Research\",\"volume\":\"13 1\",\"pages\":\"106\"},\"PeriodicalIF\":11.5000,\"publicationDate\":\"2025-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366021/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomarker Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40364-025-00816-9\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomarker Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40364-025-00816-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Salvage therapy containing sorafenib and donor lymphocyte infusion is associated with improved outcomes for FLT3 wild-type acute myeloid leukemia relapsing after allogeneic hematopoietic stem cell transplantation.
Background: There is no established standard treatment for acute myeloid leukemia (AML) patients with FLT3 wild-type relapsing after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Multi-kinase inhibitor sorafenib has been widely explored in the treatment of AML patients with FLT3 internal tandem duplication (FLT3-ITD) mutations. Some studies have revealed that the addition of sorafenib to standard chemotherapy could improve outcomes in newly diagnosed AML regardless of FLT3 status. However, the application of sorafenib in FLT3 wild-type AML patients experiencing relapse after allo-HSCT remains minimally investigated.
Methods: We retrospectively compared the effects of conventional treatment combined with or without sorafenib on the outcomes of these patients. The study mainly focused on the treatment response of salvage therapy and survival.
Results: Sixty-two AML patients with FLT3 wild-type who relapsed after allo-HSCT were enrolled in this study, including 38 with sorafenib and 24 without sorafenib. Fifty patients received 68 doses of donor lymphocyte infusion (DLI). The rate of composite complete remission was 65.8% in the sorafenib group, compared with 29.2% in the non-sorafenib group (P = 0.005). With a median follow-up of 13.2 months (IQR, 3.2-43.5) after relapse, the 2-year overall survival (OS) was 47.4% (95%CI, 33.9%-66.2%) and 16.7% (6.8%-40.8%) in the sorafenib and non-sorafenib groups (P = 0.006). The 2-year event-free survival (EFS) was 44.7% (31.4%-63.7%) and 16.7% (6.8%-40.8%) in the two groups (P = 0.012). Multivariable analysis revealed that salvage therapy including sorafenib was the protective factor for longer OS and EFS (HR = 0.395, 95% CI: 0.209-0.746, P = 0.004; HR = 0.406, 95% CI: 0.218-0.754, P = 0.004). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were similar between the two groups (P = 0.806, P = 0.908).
Conclusion: Our results suggest that salvage therapy including sorafenib and DLI is associated with improved outcomes for AML patients with FLT3 wild-type relapsing after allo-HSCT.
Biomarker ResearchBiochemistry, Genetics and Molecular Biology-Molecular Medicine
CiteScore
15.80
自引率
1.80%
发文量
80
审稿时长
10 weeks
期刊介绍：
Biomarker Research, an open-access, peer-reviewed journal, covers all aspects of biomarker investigation. It seeks to publish original discoveries, novel concepts, commentaries, and reviews across various biomedical disciplines. The field of biomarker research has progressed significantly with the rise of personalized medicine and individual health. Biomarkers play a crucial role in drug discovery and development, as well as in disease diagnosis, treatment, prognosis, and prevention, particularly in the genome era.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
