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Molecular remission of FLT3-ITD+ positive AML relapse after allo-SCT by acute GVHD in addition to sorafenib

Bone Marrow Transplantation volume 47, pages 137–138 (2012)Cite this article

Molecular markers such as alterations of the FLT3 or NPM1 gene have become factors of prognostic relevance for patients with cytogenetically normal AML. Mutations of the FLT-3 have been reported to worsen the prognosis in AML. On the other hand they provide a target for a potentially promising new therapeutic approach using the multi-kinase inhibitor sorafenib.1, 2

The presented case shows that sorafenib in conjunction with GVL effects has the power to improve a clinical remission into a molecular remission after second relapse of a FLT3+ AML. It must be stated that it is impossible to discriminate the contribution of both compounds, however, the follow-up of minimal residual disease in blood and marrow suggests a synergy of both effects. Earlier remissions have been considerably shorter than the third under sorafenib plus cGVHD, and more intensive and effective treatment of extensive cGVHD after the first relapse with CsA, prednisolone and photopheresis has lead to the second relapse. Presently, cGVHD is well controlled and the patient is still MRD-negative at a sensitivity of 10−5 in the presence of oral therapy with 2 × 400 mg sorafenib.

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  1. Department of Internal Medicine C (Haematology and Oncology, Transplant Centre), Ernst-Moritz-Arndt-University, Greifswald, Germany

    W H Krüger, C Hirt, T Kiefer, T Neumann, C Busemann & G Dölken

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  1. W H Krüger
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  2. C Hirt
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  3. T Kiefer
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  4. T Neumann
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  5. C Busemann
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  6. G Dölken
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Correspondence to W H Krüger.

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Krüger, W., Hirt, C., Kiefer, T. et al. Molecular remission of FLT3-ITD+ positive AML relapse after allo-SCT by acute GVHD in addition to sorafenib. Bone Marrow Transplant 47, 137–138 (2012). https://doi.org/10.1038/bmt.2011.7

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