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Efficacy and feasibility of sorafenib as a maintenance agent after allogeneic hematopoietic stem cell transplantation for Fms-like tyrosine kinase 3-mutated acute myeloid leukemia
- Source :
- Cancer, Cancer, Wiley, 2017, 123 (15), pp.2867-2874. ⟨10.1002/cncr.30680⟩
- Publication Year :
- 2017
- Publisher :
- HAL CCSD, 2017.
-
Abstract
- BACKGROUND: Sorafenib has shown encouraging results in patients with Fms-like tyrosine kinase 3 (FLT3)-positive acute myeloid leukemia. Its role after allogeneic stem cell transplantation (HSCT) has been reported in a few cases with encouraging results. METHODS: The authors describe the use of sorafenib as a maintenance agent after HSCT in 27 patients with FLT3-positive acute myeloid leukemia. RESULTS: The median age of the patients was 46 years (range, 15-57 years). Sorafenib was introduced at a median of 70 days (range, 29-337 days) after HSCT. The median treatment duration was 8.4 months (range, 0.2-46 months). Eleven patients experienced treatment toxicities, mainly of grade 1 to 2 (graded according to the National Cancer Institute Common Toxicity Criteria [version 4.0]). Dose reduction or withdrawal was required in 4 patients and 4 patients, respectively. The persistence of toxicity prompted treatment withdrawal in 1 patient. Clinical improvement followed dose modifications. Thirteen patients experienced chronic graft-versus-host disease (limited in 9 patients and extensive in 4 patients), resulting in dose reduction in 5 patients followed by withdrawal in 1 of these individuals. At a median follow-up of 18 months (range, 4-48 months), 25 patients were alive (all of whom were in complete molecular remission) and 18 were still receiving treatment, with 1-year overall survival and progression-free survival rates of 92% ± 6% and 92% ± 5%, respectively. CONCLUSIONS: Sorafenib treatment after HSCT appears to be feasible and highly effective with dose individualization according to patient tolerability. Further analysis is needed to evaluate the immunomodulating role of sorafenib after HSCT. The data from the current support prospective controlled trials of sorafenib after HSCT. Cancer 2017;123:2867–74. © 2017 American Cancer Society.
- Subjects :
- Adult
Male
Niacinamide
Phenylurea Compound
Fms-like tyrosine kinase 3 (FLT3)
Adolescent
[SDV]Life Sciences [q-bio]
Graft vs Host Disease
Antineoplastic Agents
Disease-Free Survival
maintenance
Maintenance Chemotherapy
Antineoplastic Agent
Young Adult
acute myeloid leukemia (AML)
allogeneic stem cell transplantation
Retrospective Studie
Humans
Transplantation, Homologous
Transplantation, Homologou
ComputingMilieux_MISCELLANEOUS
Retrospective Studies
Phenylurea Compounds
Hematopoietic Stem Cell Transplantation
[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Middle Aged
Sorafenib
Feasibility Studie
Leukemia, Myeloid, Acute
Treatment Outcome
fms-Like Tyrosine Kinase 3
Chemotherapy, Adjuvant
Feasibility Studies
Female
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Human
Subjects
Details
- Language :
- English
- ISSN :
- 0008543X and 10970142
- Database :
- OpenAIRE
- Journal :
- Cancer, Cancer, Wiley, 2017, 123 (15), pp.2867-2874. ⟨10.1002/cncr.30680⟩
- Accession number :
- edsair.pmid.dedup....35ebb78f3a8ad0ccfa604f27d0c4241c