Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 116, Issue 6, Pages 883-891Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12185-022-03427-4
Keywords
Sorafenib maintenance; FLT3-ITD mutation; Acute myeloid leukemia; Hematopoietic stem cell transplantation
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In a retrospective analysis, the effectiveness of sorafenib maintenance therapy for patients with acute myeloid leukemia (AML) was evaluated. The study found that sorafenib maintenance significantly improved the cumulative incidence of relapse and overall survival, especially in AML patients with FLT3-ITD mutation.
In a retrospective analysis, 21 acute myeloid leukemia patients receiving single-agent sorafenib maintenance therapy in complete remission (CR) after hematopoietic stem cell transplantation (HSCT) were compared with a control group of 22 patients without maintenance. Sorafenib was initiated a median of 3 months (IQR: 2.3-3.5) after allogeneic HSCT with a median daily dosage of 400 mg (range: 200-800) orally, and lasted a median of 11.3 months (IQR: 3.3-24.4). No significant increase in graft versus host disease or toxicity was observed. Adverse events were reversible with dose adjustment or temporary discontinuation in 19/19 cases. With a median follow-up of 34.7 months (IQR: 16.9-79.5), sorafenib maintenance significantly improved cumulative incidence of relapse (p = 0.028) as well as overall survival (OS) (p = 0.016), especially in patients undergoing allogeneic HSCT in CR1 (p < 0.001). In conclusion, sorafenib maintenance after allogeneic HSCT is safe and may improve cumulative incidence of relapse and OS in FLT3-ITD-mutated AML.
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