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Posted by on Nov 13, 2017 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate if sorafenib (Nexavar) would be a useful maintenance therapy for acute myeloid leukemia patients who have received a stem cell transplant.

This study concluded that sorafenib is useful as a maintenance therapy in these patients. 

Some background

Acute myeloid leukemia (AML) occurs when abnormal myeloblasts are produced. Myeloblasts are a type of white blood cell that produce other cells. Abnormal myeloblasts cannot produce healthy cells. Lack of healthy cells can lead to a weak immune system, infection and bleeding. 

A hematopoietic stem cell transplant (HSCT) is the standard treatment option for AML. It involves taking stem cells from a donor and putting them into the AML patient. Stem cells can produce any cell type and help to restore the immune system. Patients with certain genetic abnormalities, such as the FLT3-ITD, tend to have a worse prognosis.

Sorafenib is a kinase inhibitor drug. It has shown encouraging results in patients with FLT3-positive AML. It was unknown if sorafenib would be useful as a maintenance therapy (prevent cancer returning) after HSCT for FLT3-positive AML patients.

Methods & findings

This study involved 27 patients with FLT3-positive AML who received HSCT. The patients received sorafenib as a maintenance agent after HSCT. Patients were treated for an average of 8.4 months. Patients were followed for an average of 18 months.

40.7% of patients had side effects with treatment. These were mainly of grade 1 and 2 (not severe). Dose reduction was required in 14.8% of patients, as was withdrawal (another 14.8%). One patient needed treatment withdrawal due to persistent side effects.

48% of patients experienced chronic graft-versus-host-disease (GVHD). GVHD is when the body starts attacking its own cells. 

The average 1-year overall survival rate (time from treatment until death from any cause) was 92%. The 1-year progression free survival rate (time from treatment until disease progression) was 92%. 

The bottom line

This study concluded that sorafenib treatment after HSCT is highly effective. The authors suggest that doses should be individualized for each patient. 

The fine print

Further studies are needed in larger groups of patients. 

What’s next?

Consult your physician about clinical trials which may use sorafenib.

Published By :

Cancer

Date :

Apr 07, 2017

Original Title :

Efficacy and feasibility of sorafenib as a maintenance agent after allogeneic hematopoietic stem cell transplantation for Fms-like tyrosine kinase 3-mutated acute myeloid leukemia.

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