From the Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and Department of Internal Medicine, Creighton University Medical Center, and Department of Internal Medicine, Division of Hematology and Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
J Natl Compr Canc Netw. 2015 May;13(5):508-14. doi: 10.6004/jnccn.2015.0070.
Old age (≤65 years), relapsed or refractory disease, and the presence of FMS-like receptor tyrosine kinase-3 (FLT3) internal tandem duplication (ITD) mutation are poor prognostic factors in acute myeloid leukemia (AML). FLT3 inhibitors such as sorafenib have been shown to have a potential role in treating relapsed or refractory AML with FLT3 mutations. In the present report, the use of sorafenib in combination with cytarabine and idarubicin resulted in disease control for 7 months in an older patient with relapsed FLT3-positive AML. This case report and the existing literature indicate that sorafenib has disease activity against relapsed AML with the FLT3-ITD mutation in older patients. Larger multicenter studies should be conducted to confirm these findings, which have the potential to improve outcomes in this high-risk AML subgroup.
老年（≤65 岁）、疾病复发或难治以及存在 FMS 样酪氨酸激酶-3（FLT3）内部串联重复（ITD）突变是急性髓系白血病（AML）的不良预后因素。已经证实，FLT3 抑制剂如索拉非尼在治疗具有 FLT3 突变的复发或难治性 AML 方面具有潜在作用。在本报告中，索拉非尼联合阿糖胞苷和伊达比星治疗复发性 FLT3 阳性 AML 的老年患者，疾病得到了 7 个月的控制。该病例报告和现有文献表明，索拉非尼对老年具有 FLT3-ITD 突变的复发 AML 具有疾病活性。应开展更大规模的多中心研究来证实这些发现，这有可能改善该高危 AML 亚组的治疗结局。
