Study of Ponatinib (Iclusig) for Prevention of Relapse After Allogeneic Stem Cell Transplantation (allo-SCT) in FLT3-ITD AML Patients

Inclusion criteria

• Engraftment
• Controlled GVHD
• Positive FLT-3 ITD AML in cytologic complete remission
• Have an Eastern Cooperative Oncology Group (ECOG) performance status < 2
• Have adequate renal function: Serum creatinine ≤ 1.5 × upper limit of normal (ULN) for institution
• Have adequate hepatic function: Total serum bilirubin ≤ 1.5 × ULN, unless due to Gilbert's syndrome; Alanine aminotransferase (ALT) ≤ 2.5 × ULN, or ≤ 5 × ULN if leukemic infiltration of the liver is present ; Aspartate aminotransferase (AST) ≤ 2.5 × ULN, or ≤ 5 × ULN if leukemic infiltration of the liver is present
• Have normal pancreatic status: Serum lipase and amylase ≤ 1.5 × ULN
• Have normal QTcF interval on screening electrocardiogram (ECG) evaluation,defined as QTcF of ≤ 450 ms in males or ≤ 470 ms in females.
• Platelets ≥ 100 Giga/l; Neutrophils ≥ 1 Giga/l
• Have a negative pregnancy test documented prior to enrollment (for females of childbearing potential).
• Agree to use an effective form of contraception with sexual partners throughout study participation (for female and male patients who are fertile).
• Provide written informed consent.
• Be willing and able to comply with scheduled visits and study procedures.

Exclusion criteria

• HIV positive, active Hepatitis B or C
• Childbearing or childbreast feeding women
• Women or men without effective contraceptive barrier if needed
• Previous myocardial infarction, or cerebral vascular accident, pancreatitis
• Respiratory insufficiency defined as DLCO <40% of the corrected value
• Creatinine clearance ≤ 50ml/min
• Contra-indication to ponatinib
• Previous or concurrent second malignancy except for adequately treated basal cell carcinoma of the skin, curatively treated in situ carcinoma of the cervix, curatively treated solid cancer, with no evidence of disease for at least 2 years
• Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
• Patients at high or very high risk of cardiovascular disease with any of the following

• Established cardiovascular disease Cardiac disease:

• Congestive heart failure greater than class II NYHA or
• Left ventricular ejection fraction (LVEF) < 50% or
• Unstable angina (anginal symptoms at rest) or
• New onset angina (began within the last 3 months) or
• Myocardial infarction, coronary/peripheral artery disease, congestive heart failure, cerebrovascular accident including transient ischemic attack within the past 12 months or
• History of thrombolic or embolic events Arrhythmias
• Any history of clinically significant cardiac arrhythmias requiring anti-arrhythmic therapy.
• Diabetes Mellitus,
• Arterial Hypertension,

• Uncontrolled hypertension defined as systolic blood pressure greater than 140 mmHg or diastolic pressure greater than 90 mmHg, despite optimal medical management and optimal measurement (http://www.has-sante.fr/portail/display.jsp?id=c_272459)
• Any history of hypertension with
• Hypertensive encephalopathy
• Posterior leucoencephalopathy
• Aortic or artery dissection
• Familial dysplipidemia.
• Taking medications that are known to be associated with Torsades de Pointes (see