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Open Access 01-12-2013 | Case report

Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature

Authors: Denise Wolleschak, Enrico Schalk, Christian Krogel, Tina M Schnoeder, Helga Luehr, Kathleen Jentsch-Ullrich, Thomas Fischer, Florian H Heidel

Published in: Journal of Hematology & Oncology | Issue 1/2013

Abstract

Treatment of acute myeloid leukemia remains a therapeutic challenge. Even in younger patients with a low rate of co-morbidities less than 50% of patients can be cured. For older patients or patients with significant co-morbidities, the situation appears even worse. In patients not eligible for intensive treatment approaches - e.g. due to underlying medical conditions - therapeutic approaches remain almost exclusively palliative. However, even with less intense treatment approaches, temporary remission can be achieved and this contributes to prolonged survival and improved quality of life of the respective patient. Targeted therapies have been widely used as palliative treatment in- and outside clinical trials as single agents. Combination with low-dose cytarabine (LDAC) potentially improves remission rates and can be safely administered in an outpatient setting.

Previous studies showed that additive hematologic toxicity of combinatory therapeutic approaches may arise from simultaneous treatment (e.g. chemotherapy plus targeted therapies). However, sequential therapies have already proven their feasibility in clinical trials. Here, we report two cases of rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in patients unfit for intensive chemotherapy without significant long-term toxicity.

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Title: Rapid induction of complete molecular remission by sequential therapy with LDAC and sorafenib in FLT3-ITD-positive patients unfit for intensive treatment: two cases and review of the literature
Authors: Denise Wolleschak
Enrico Schalk
Christian Krogel
Tina M Schnoeder
Helga Luehr
Kathleen Jentsch-Ullrich
Thomas Fischer
Florian H Heidel
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Journal of Hematology & Oncology / Issue 1/2013
Electronic ISSN: 1756-8722
DOI: https://doi.org/10.1186/1756-8722-6-39

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