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Sorafenib and azacitidine as salvage therapy for relapse of FLT 3‐ ITD mutated AML after allo‐ SCT
Author(s) -
Rautenberg Christina,
Nachtkamp Kathrin,
Dienst Ariane,
Schmidt Pia Verena,
Heyn Claudia,
Kondakci Mustafa,
Germing Ulrich,
Haas Rainer,
Kobbe Guido,
Schroeder Thomas
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12832
Subject(s) - azacitidine , sorafenib , medicine , cancer research , biology , genetics , gene , gene expression , hepatocellular carcinoma , dna methylation
Objective Patients with acute myeloid leukemia ( AML ) carrying FLT 3‐ ITD mutations ( FLT 3‐ ITD +) who relapse after allogeneic transplantation (allo‐ SCT ) have a very dismal prognosis with the currently available treatment options. Methods We treated eight patients with FLT 3‐ ITD + AML who had relapsed in median 91 d (range, 28–249) following allo‐ SCT with a combination of the multikinase inhibitor sorafenib and the DNA methyltransferase inhibitor azacitidine (Aza). Results Patients received a median of five cycles of Aza (range, 2–9) and sorafenib with a median daily dosage of 750 mg (range 400–800) for 129 d (range, 61–221). Six of eight patients received donor lymphocyte infusions ( DLI ) with a median number of two DLI per patient (range, 1–4). Following this treatment, four patients (50%) achieved a complete remission and three of them a complete molecular remission. Median duration of CR was 182 d (range, 158–406), and two patients remain in ongoing remission for 406 and 168 d. Median overall survival was 322 d (range, 108–574 d) with three patients being currently alive. Conclusion Taken together, the combination of sorafenib, Aza, and DLI shows promising efficacy and deserves further evaluation in larger patient groups.