Treatment of FLT3-ITD-positive acute myeloid leukemia relapsing after allogeneic stem cell transplantation with sorafenib

Manish Sharma, Farhad Ravandi, Ulas Darda Bayraktar, Alexandre Chiattone, Qaiser Bashir, Sergio Giralt, Julianne Chen, Muzaffar Qazilbash, Partow Kebriaei, Marina Konopleva, Michael Andreeff, Jorge Cortes, Deborah McCue, Hagop Kantarjian, Richard E. Champlin, Marcos De Lima

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Patients with acute myeloid leukemia (AML) and internal tandem duplication of FMS-like tyrosine kinase receptor-3 gene (FLT3-ITD) mutation have poor prognoses and are often treated with allogeneic hematopoietic stem cell transplantation (HSCT). Sorafenib, an inhibitor of multiple kinases including FLT3, has shown promising activity in FLT3-ITD-positive AML. We treated 16 patients with FLT3-ITD-positive AML who relapsed after HSCT with sorafenib alone (n = 8) or in combination with cytotoxic chemotherapy (n = 8). The number of circulating blasts decreased in 80% of cases, but none of the patients achieved complete remission (CR); 3 achieved partial remission. Two patients were bridged to a second transplantation but both relapsed within 3 months of the transplantation. Median overall survival (OS) was 83 days, with none surviving more than a year. Sorafenib is not effective in the treatment of FLT3-ITD-positive AML relapsing after HSCT. Preventive strategies after HSCT may be more suitable for these high-risk patients.

Original languageEnglish (US)
Pages (from-to)1874-1877
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume17
Issue number12
DOIs
StatePublished - Dec 2011

Keywords

  • Acute myeloid leukemia
  • FLT3
  • Sorafenib
  • Stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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