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Current Approaches to Transplantation for FLT3-ITD AML

Abstract

Purpose of Review

This review discusses the current standard of care for incorporation of FLT3 TKIs and HCT into the treatment of FLT3-ITD AML. Additionally, this review provides an approach to the patient with relapsed/refractory disease.

Recent Findings

Over the last decade, the routine use of HCT as consolidative therapy and the development of FLT3 TKIs have significantly improved remission rates and overall survival. The value and challenges of MRD assessment in FLT3 disease are discussed and current mechanisms of relapse are explored, as are the ongoing questions in the field that current clinical trials are seeking to answer.

Summary

FLT3-ITD mutations are common in acute myeloid leukemia and historically have been associated with a poor prognosis, but with the incorporation of FLT3 TKIs and routine use of allogeneic stem cell transplant as consolidative therapy, outcomes have improved dramatically. Ongoing research seeks to answer how and when to best use current therapies, and how to overcome resistance to FLT3 inhibition.

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Correspondence to Yi-Bin Chen.

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Conflict of Interest

YBC has served as a consultant for Takeda, Incyte, and Magenta and on clinical trial adjudication committees for Equilium, Abbvie, and Daiichi. BDH has no conflicts of interest to report.

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Hunter, B.D., Chen, Y. Current Approaches to Transplantation for FLT3-ITD AML. Curr Hematol Malig Rep (2020). https://doi.org/10.1007/s11899-020-00558-5

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Keywords

  • FLT3-ITD
  • AML
  • TKI