Sorafenib in combination with chemotherapy as first-line therapy for FLT3-ITD positive acute myeloid leukemia
10.3760/cma.j.issn.0253-2727.2017.05.012
- VernacularTitle: 索拉非尼联合化疗一线治疗FLT3-ITD突变阳性急性髓系白血病的临床对照研究
- Author:
Qingyu ZHANG
1
,
2
;
Xudong WEI
;
Qingsong YIN
;
Ruihua MI
;
Fangfang YUAN
;
Lin CHEN
Author Information
1. Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University
2. Henan Cancer Hospital, Zhengzhou 450008, China
- Publication Type:Journal Article
- Keywords:
FLT3-ITD mutation;
Sorafenib;
Leukemia, myeloid, acute
- From:
Chinese Journal of Hematology
2017;38(5):415-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features of acute myeloid leukemia patients with Fms-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutation and the therapeutic effect of sorafenib in combination with chemotherapy as first-line therapy for these patients.
Methods:Clinical features and therapeutic effect were retrospectively analyzed in 53 AML patients with FLT3-ITD mutation diagnosed in Henan Cancer Hospital from January 2013 to August 2016. The biological characteristics and clinical efficacy of chemotherapy in combination with or without Sorafeinb were analyzed.
Results:FLT3-ITD mutation was identified in 53 AML patients, 22 cases (41.5%) were M5 subtype. The median of the peripheral WBC was 61.00 (0.98-920.00) ×109/L, and there were 50 (94.3%) patients with WBC>10×109/L. The median of blast cell in bone marrow was 0.730 (0.234-0.966) . The total remission rate of all these 53 patients was 56.6% (30/53) . The complete remission (CR) rates in patients treated with chemotherapy in combination with sorafenib and patients with chemotherapy alone were 86.4% (19/22) and 35.5% (11/31) , respectively. The 1-year overall survival rates of the two groups were 78.3%% and 50.0% (P=0.041) , and 1-year progression free survival rates were 75.9% and 42.4% (P=0.044) , respectively.
Conclusion:AML patients with FLT3-ITD mutation have the characteristics of high peripheral WBC, high blast cells in bone marrow and accompanying with M5 subtype. Sorafeinb combined with chemotherapy can significantly improve CR rate and short term survival.
