Salvage therapy using FLT3 inhibitors may improve long-term outcome of relapsed or refractory AML in patients with FLT3-ITD

被引：19

作者：

Takahashi, Koichi ^{[1
,4
]}

Kantarjian, Hagop ^{[2
]}

Pemmaraju, Naveen ^{[2
]}

Andreeff, Michael ^{[2
]}

Borthakur, Gautam ^{[2
]}

Faderl, Stefan ^{[2
]}

Garcia-Manero, Guillermo ^{[2
]}

Pierce, Sherry ^{[2
]}

Luthra, Rajyalakshmi ^{[3
]}

Cardenas-Turanzas, Marylou ^{[2
]}

Estrov, Zeev ^{[2
]}

Ravandi, Farhad ^{[2
]}

Cortes, Jorge ^{[2
]}

机构：

[1] Univ Texas MD Anderson Canc Ctr, Div Canc Med, Houston, TX 77030 USA

[2] Univ Texas MD Anderson Canc Ctr, Dept Leukemia, Houston, TX 77030 USA

[3] Univ Texas MD Anderson Canc Ctr, Dept Hematopathol, Houston, TX 77030 USA

[4] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2013年 / 161卷 / 05期

关键词：

acute myeloid leukemia; FLT3; inhibitors; FLT3-ITD; ACUTE MYELOID-LEUKEMIA; INTERNAL TANDEM DUPLICATION; NORMAL CYTOGENETICS; KINASE INHIBITOR; WILD-TYPE; MUTATIONS; SORAFENIB; PROGNOSIS; RECOMMENDATIONS; CLASSIFICATION;

D O I：

10.1111/bjh.12299

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

To determine the long-term efficacy of FLT3 inhibitors (FLT3i) in the salvage setting for relapsed and refractory (rel/ref) acute myeloid leukemia (AML) with FLT3 internal tandem duplication (AML FLT3-ITD), we conducted a retrospective study of 120 patients with rel/ref AML FLT3-ITD who received salvage therapy with either FLT3i-containing regimen (FLT3i group, N=45) or conventional cytotoxic regimen (conventional group, N=75). The median overall survival (OS) after the first salvage in the FLT3i group was 6 center dot 9 vs. 4 center dot 6months in the conventional group (P=0 center dot 17). The OS was better in the FLT3i group among patients with initial complete remission (CR) duration 12months or with primary refractory disease (6 center dot 9 vs. 3 center dot 7months; P<0 center dot 01). The OS was better when FLT3i was combined with cytotoxic agents versus monotherapy (17 vs. 4 center dot 8months; P=0 center dot 017). Multivariate analysis revealed that the use of FLT3i was an independent predictor of OS (hazard ratio 0 center dot 58; 95% confidence interval, 0 center dot 380 center dot 88). Incorporating FLT3i into salvage strategies may improve long-term outcome of patients with AML FLT3-ITD. Prospective studies to validate this conclusion are warranted.

引用

页码：659 / 666

页数：8

共 27 条

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