4.7 Review

A Review of FLT3 Kinase Inhibitors in AML

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 12, Issue 20, Pages -

Publisher

MDPI
DOI: 10.3390/jcm12206429

Keywords

acute myeloid leukemia; FLT3 inhibitors; therapeutics; molecular biology; prognosis

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Acute myeloid leukemia (AML) is an aggressive disease characterized by the accumulation of abnormal hematopoietic precursors. FLT3 gene mutations increase the risk of relapse and mortality. FLT3 mutation screening is mandatory for AML patients, and FLT3 inhibitors are crucial for treatment. FLT3-ITD is the most common mutation type, while FLT3-TKD affects a smaller percentage. FLT3 inhibitors are now vital in treating AML patients with FLT3 mutations.
Acute myeloid leukemia (AML) is a highly aggressive illness distinguished by the accumulation of abnormal hematopoietic precursors in both the bone marrow and peripheral blood. The prevalence of FLT3 gene mutations is high and escalates the probability of relapse and mortality. The survival rates for AML patients, particularly those over 65, are low. FLT3 mutation screening at diagnosis is mandatory, and FLT3 inhibitors are crucial in treating AML patients with mutations. There are two categories of FLT3 mutations: FLT3-ITD located in the juxtamembrane domain and FLT3-TKD in the tyrosine kinase domain. FLT3-ITD is the most common type, affecting nearly a quarter of patients, whereas FLT3-TKD only affects 6-8% of patients. FLT3 inhibitors are now crucial in treating AML patients with FLT3 mutations. When dealing with FLT3-mutated AML, the recommended course of treatment typically involves chemotherapy and midostaurin, followed by allogeneic hematopoietic cell transplantation (HCT) to maximize the likelihood of success. Maintenance therapy can lower the risk of relapse, and gilteritinib is a better option than salvage chemotherapy for relapsed or refractory cases. Clinical trials for new or combined therapies are the most effective approach. This review discusses treatment options for patients with FLT3-mutated AML, including induction chemotherapy and options for relapsed or refractory disease. Additional treatment options may become available as more studies are conducted based on the patient's condition and susceptibility.

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