Volume 5, Issue 6, November 2019, Page: 92-97
FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib
Xu Jianhui, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Yao Qianqian, Hematology Department, Shunde Hospital of Sourthern Medical University, Foshan, China
Zhong Yuxia, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
He Yingzhi, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Du Jingwen, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Liu Minhong, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Huang Yuxian, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Li Yuhua, Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Wu Bingyi, Hematology Department, Shunde Hospital of Sourthern Medical University, Foshan, China
Received: Oct. 23, 2019;       Accepted: Nov. 23, 2019;       Published: Dec. 2, 2019
DOI: 10.11648/j.ijcems.20190506.11      View  87      Downloads  45
Abstract
There are great needs to explore more efficient and low-cytotoxic treatment for refractory/relapsed (R/R) or old acute myeloid leukemia (AML) patients without FLT3-ITD mutation. We observed the procedures and outcomes of 13 such patients subsequently treated by sorafenib in our departments. Five of them used low-dose cytorabine concomitantly and 8 patients took sorafenib alone as induction therapy. Five patients achieved complete remission (CR) and the needed time ranged from 31 to 100 days. Four patients achieved CR by concomitantly using low-dose cytorabine and sorafenib, but only one patient achieved CR by taking sorafenib alone. The difference of CR induction rates between the two groups was significant. Sorafenib was then prescribed as the maintenance treatment to these AML patients achieving CR until adverse event happening or stem cell transplantation received. Only one patient developed adverse event of grade 3 during the maintenance with sorafenib and it was relieved by withdrawal of the drug. The event free survival with sorafenib ranged from 2 to 20 months. The median survival time of these CR patients was 520 days since the beginning of taking sorafenib. The median survival time of those not achieved CR with sorafenib was 344 days. But we found no significant differences of survival time between those achieving and not achieving CR. Our results of the observation suggested a group of R/R or geratic AML patients unfit for intensive chemotherapy induction and without FLT3-ITD mutation may well respond to single sorafenib treatment. The combination of low-dose cytarabine with sorafenib improved the response rate comparing with using sorafenib alone. This treatment is safe and the survival time is acceptable for such formidable patients.
Keywords
Sorafenib, Cytorabine, Refractory or Relapsed Acute Myeloid Leukemia, Old Acute Myeloid Leukemia, FLT3-ITD Mutation, Clinical Observation
To cite this article
Xu Jianhui, Yao Qianqian, Zhong Yuxia, He Yingzhi, Du Jingwen, Liu Minhong, Huang Yuxian, Li Yuhua, Wu Bingyi, FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib, International Journal of Clinical and Experimental Medical Sciences. Vol. 5, No. 6, 2019, pp. 92-97. doi: 10.11648/j.ijcems.20190506.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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