4.3 Article

Post-transplantation maintenance with sorafenib or midostaurin for FLT3 positive AML patients - a multicenter retrospective observational study

Journal

LEUKEMIA & LYMPHOMA
Volume 62, Issue 10, Pages 2475-2481

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2021.1913145

Keywords

Acute myeloid leukemia; FLT3 inhibitors; post-transplantation maintenance

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The study demonstrates that post-transplant use of TKIs is safe and effective in improving overall survival of patients with acute myeloid leukemia, especially in the era of widespread pre-transplant use of these agents. Most patients maintained complete remission after transplantation, with those receiving pre-transplant TKIs showing similar outcomes.
The role of post allogeneic stem-cell transplantation (AlloSCT) FLT3 inhibition for acute myeloid leukemia in the real-world setting is unclear, especially in the era of widespread pre-transplant use of tyrosine kinase inhibitors (TKIs). In a multicenter nationwide study, we assessed 41 patients who were treated with post-transplant TKIs (sorafenib, n = 23, midostaurin, n = 18). The majority also received TKIs pre-transplant (n = 32, 79%). After a median follow up of 10 months post-transplant (range 3-53.6), 29 patients (71%) were alive and in complete remission. Similar results were seen in a subgroup analysis of pre-transplant TKI recipients (78%). In Univariate analysis, HCT-CI score < 4 and Type of TKI (sorafenib versus midostaurin) predicted longer overall survival. Seventeen patients (41%) suffered from side effects and seven patients (17%) stopped TKI therapy due to adverse events. Overall, our data suggest that post-transplant use of TKIs is safe and effective in an era of their widespread use prior to AlloSCT.

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