Salvage therapy using FLT3 inhibitors may improve long-term outcome of relapsed or refractory AML in patients with FLT3-ITD

Koichi Takahashi, Hagop Kantarjian, Naveen Pemmaraju, Michael Andreeff, Gautam Borthakur, Stefan Faderl, Guillermo Garcia-Manero, Sherry Pierce, Rajyalakshmi Luthra, Marylou Cardenas-Turanzas, Zeev Estrov, Farhad Ravandi, Jorge Cortes

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

To determine the long-term efficacy of FLT3 inhibitors (FLT3i) in the salvage setting for relapsed and refractory (rel/ref) acute myeloid leukemia (AML) with FLT3 internal tandem duplication (AML FLT3-ITD), we conducted a retrospective study of 120 patients with rel/ref AML FLT3-ITD who received salvage therapy with either FLT3i-containing regimen (FLT3i group, N = 45) or conventional cytotoxic regimen (conventional group, N = 75). The median overall survival (OS) after the first salvage in the FLT3i group was 6·9 vs. 4·6 months in the conventional group (P = 0·17). The OS was better in the FLT3i group among patients with initial complete remission (CR) duration ≤12 months or with primary refractory disease (6·9 vs. 3·7 months; P < 0·01). The OS was better when FLT3i was combined with cytotoxic agents versus monotherapy (17 vs. 4·8 months; P = 0·017). Multivariate analysis revealed that the use of FLT3i was an independent predictor of OS (hazard ratio 0·58; 95% confidence interval, 0·38-0·88). Incorporating FLT3i into salvage strategies may improve long-term outcome of patients with AML FLT3-ITD. Prospective studies to validate this conclusion are warranted.

Original languageEnglish (US)
Pages (from-to)659-666
Number of pages8
JournalBritish Journal of Haematology
Volume161
Issue number5
DOIs
StatePublished - Jun 2013

Keywords

  • Acute myeloid leukemia
  • FLT3 inhibitors
  • FLT3-ITD

ASJC Scopus subject areas

  • Hematology

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    Takahashi, K., Kantarjian, H., Pemmaraju, N., Andreeff, M., Borthakur, G., Faderl, S., Garcia-Manero, G., Pierce, S., Luthra, R., Cardenas-Turanzas, M., Estrov, Z., Ravandi, F., & Cortes, J. (2013). Salvage therapy using FLT3 inhibitors may improve long-term outcome of relapsed or refractory AML in patients with FLT3-ITD. British Journal of Haematology, 161(5), 659-666. https://doi.org/10.1111/bjh.12299