Sorafenib Improves HCT Outcomes in Patients with FLT3-ITD AML

Three-year relapse rates were cut in half when allogeneic hematopoietic cell transplantation (HCT) patients with FLT3‐ITD acute myeloid leukemia (AML) received pre-transplant sorafenib, according to results of a study of 144 patients.

Patients were divided into 4 groups: those receiving sorafenib before transplant (group A), those receiving sorafenib after transplant (group B), those receiving sorafenib both before and after transplant (group C), and those who did not receive any sorafenib (group D).

Outcomes are shown in the table below.

 Outcome Group A
 Group B
 Group C
 Group D
 3-year relapse 22.2% 18.8% 15.8% 46.1% 0.006
 3-year OS 74.9% 78.1% 84.6% 50.9% 0.023
 3-year LFS 69.4% 78.1% 80.4% 34.8% <0.001

OS = overall survival, LFS = leukemia-free survival

The relapse rate was significantly higher and the LFS was shorter in group D versus groups A, B, and C. The OS in group D was shorter than the OS in group C, but was similar to the OS in groups A and B.

A multivariate analysis revealed that sorafenib before transplant, sorafenib maintenance after transplant, and their combined application were protective factors for a lower relapse rate and leukemia-free survival. Additionally, researchers concluded that all three approaches could improve the outcomes for patients with FLT3‐ITD AML, but further study will be needed to determine the ideal timing of sorafenib.

Xuan L, et al. Cancer

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