期刊
ANNALS OF HEMATOLOGY
卷 102, 期 2, 页码 323-328出版社
SPRINGER
DOI: 10.1007/s00277-022-05075-4
关键词
AML; Relapse; Molecular patterns; Selinexor
类别
Relapse is common in AML patients and has a poor prognosis. Treatment options are limited and understanding the molecular response patterns is challenging. In this study, we analyzed the response patterns of relapsed/refractory AML patients treated with selinexor and identified subclonal patterns. One patient showed a long-term course of remission with selinexor maintenance treatment after relapse following alloHCT. This exploratory study provides insights into the effects of selinexor in AML patients.
Relapse in patients with acute myeloid leukemia (AML) is common and is associated with a dismal prognosis. Treatment options are limited and the understanding of molecular response patterns is still challenging. We analyzed the clonal response patterns of 15 patients with relapsed/refractory AML treated with selinexor in a phase II trial (SAIL). DNA was analyzed at three time points and showed a decline of mutated alleles in FLT3, SF3B1, and TP53 under SAIL treatment. Overall survival (OS) was similar between patients with declining versus persisting clones. We show an interesting long-term course of a patient who relapsed after allogeneic stem cell transplantation (alloHCT) with SF3B1- and SRSF2-mutated AML and received selinexor as maintenance treatment for 4 years. Measurable residual disease (MRD) remained detectable for 2 weeks after donor lymphocyte infusion (DLI) in this patient and then remained negative under selinexor maintenance treatment. Selinexor was tolerated well and was stopped after 4 years of SAIL treatment. We present an exploratory study and identify subclonal patterns of patients treated with selinexor.
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