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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1441254
This article is part of the Research Topic Allogenic Hematopoietic Cell Transplant in Hematological Malignancies: Controversies and Perspective View all 12 articles

Sorafenib maintenance after allogeneic stem cell transplantation in FLT3+ AML patients receiving midostaurin in the induction and consolidation: a retrospective analysis

Provisionally accepted
Giuseppe Sapienza Giuseppe Sapienza 1*Marta Castronovo Marta Castronovo 1Stefania Tringali Stefania Tringali 1Roberto Bono Roberto Bono 1Cristina Rotolo Cristina Rotolo 1ANTONINO MULE ANTONINO MULE 1Valeria Calafiore Valeria Calafiore 1Caterina Patti Caterina Patti 1Cecilia Agueli Cecilia Agueli 1Valentina Randazzo Valentina Randazzo 1Alessandra Santoro Alessandra Santoro 1Domenica Matranga Domenica Matranga 2Luca Castagna Luca Castagna 1
  • 1 Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
  • 2 Dept Health Promotion, Mother and Child care, Internal Medicine and Medical Specialties University of Palermo, University of Palermo, Palermo, Sicily, Italy

The final, formatted version of the article will be published soon.

    Acute myeloid leukemia (AML) relapse is the main cause of death after allogeneic stem cell transplant (allo-SCT). In AML FLT3+, it was shown that Sorafenib used as maintenance therapy after allo-SCT, significantly reduces the risk of relapse and death.We analyzed 29 adult patients with FLT3m AML and underwent allogeneic stem cell transplant from 2019 to 2023. All patients received midostaurin plus conventional CT during induction and consolidation. After transplantation, Sorafenib maintenance was administered in all patients independently from MRD status at transplantation. Sorafenib maintenance was applied in 18 patients out 29 patients (62%). Median time to start sorafenib was 100 days (range 37-225) and median duration of treatment was 775 days (range 140-1064). For the whole population (n=29), 2-year OS, LFS, and CIR was 76%, 68% and 28%, respectively. The median time to relapse was 137 days (range 49-246). For patients treated with sorafenib (n=18), the 2-year OS, LFS, and CIR were 94%, 84% and 11%, respectively. For the whole population, the 100-day NRM was 0% and 1-year NRM was 3%. Death was caused by transplant-associated thrombotic microangiopathy in 1 patient. For patients who were administered with Sorafenib, the 1-y NRM was 5%. Death was caused by transplant associated transplant-associated thrombotic microangiopathy. This retrospective study suggests that sorafenib maintenance seem to be effective even in patients pre-treated with midostaurin.

    Keywords: Acute myeloid leukemia (AML, relapse., Sorafenib, Allo-SCT: allogeneic stem cell transplantation, Maintenance

    Received: 30 May 2024; Accepted: 27 Aug 2024.

    Copyright: © 2024 Sapienza, Castronovo, Tringali, Bono, Rotolo, MULE, Calafiore, Patti, Agueli, Randazzo, Santoro, Matranga and Castagna. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Giuseppe Sapienza, Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy

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