International Journal of Clinical and Experimental Medical Sciences

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FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib

Received: 23 October 2019    Accepted: 23 November 2019    Published: 2 December 2019
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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.

DOI 10.11648/j.ijcems.20190506.11
Published in International Journal of Clinical and Experimental Medical Sciences (Volume 5, Issue 6, November 2019)
Page(s) 92-97
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sorafenib, Cytorabine, Refractory or Relapsed Acute Myeloid Leukemia, Old Acute Myeloid Leukemia, FLT3-ITD Mutation, Clinical Observation

References
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    Xu Jianhui, Yao Qianqian, Zhong Yuxia, He Yingzhi, Du Jingwen, et al. (2019). 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, 5(6), 92-97. https://doi.org/10.11648/j.ijcems.20190506.11

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    ACS Style

    Xu Jianhui; Yao Qianqian; Zhong Yuxia; He Yingzhi; Du Jingwen, et al. FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib. Int. J. Clin. Exp. Med. Sci. 2019, 5(6), 92-97. doi: 10.11648/j.ijcems.20190506.11

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    AMA Style

    Xu Jianhui, Yao Qianqian, Zhong Yuxia, He Yingzhi, Du Jingwen, et al. FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib. Int J Clin Exp Med Sci. 2019;5(6):92-97. doi: 10.11648/j.ijcems.20190506.11

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  • @article{10.11648/j.ijcems.20190506.11,
      author = {Xu Jianhui and Yao Qianqian and Zhong Yuxia and He Yingzhi and Du Jingwen and Liu Minhong and Huang Yuxian and Li Yuhua and Wu Bingyi},
      title = {FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {5},
      number = {6},
      pages = {92-97},
      doi = {10.11648/j.ijcems.20190506.11},
      url = {https://doi.org/10.11648/j.ijcems.20190506.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20190506.11},
      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.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - FLT3-ITD Negative Refractory/Relapsed or Geratic AML Patients Responded Well to Salvage Treatment with Low Dose Cytarabine and Sorafenib
    AU  - Xu Jianhui
    AU  - Yao Qianqian
    AU  - Zhong Yuxia
    AU  - He Yingzhi
    AU  - Du Jingwen
    AU  - Liu Minhong
    AU  - Huang Yuxian
    AU  - Li Yuhua
    AU  - Wu Bingyi
    Y1  - 2019/12/02
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcems.20190506.11
    DO  - 10.11648/j.ijcems.20190506.11
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 92
    EP  - 97
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20190506.11
    AB  - 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.
    VL  - 5
    IS  - 6
    ER  - 

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Author Information
  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Shunde Hospital of Sourthern Medical University, Foshan, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China

  • Hematology Department, Shunde Hospital of Sourthern Medical University, Foshan, China

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