Blood and Marrow Transplant Program, Intermountain Healthcare, Salt Lake City, UT, USA.
Massachusetts General Hospital, 0 Emerson Place, Suite 118, Boston, MA, 02114, USA.
Curr Hematol Malig Rep. 2020 Feb;15(1):1-8. doi: 10.1007/s11899-020-00558-5.
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.
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. 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.
本文讨论了目前将 FLT3 TKI 和 HCT 纳入 FLT3-ITD AML 治疗的标准，并为复发性/难治性疾病患者提供了一种治疗方法。
在过去十年中，HCT 作为巩固治疗的常规应用以及 FLT3 TKI 的发展，显著提高了缓解率和总生存率。本文讨论了 MRD 评估在 FLT3 疾病中的价值和挑战，探讨了目前复发的机制，以及当前临床试验试图回答的领域内的问题。FLT3-ITD 突变在急性髓细胞白血病中很常见，历史上与预后不良相关，但随着 FLT3 TKI 的应用和常规使用异基因造血干细胞移植作为巩固治疗，其预后显著改善。目前的研究旨在回答如何以及何时最好地使用现有疗法，以及如何克服对 FLT3 抑制的耐药性。
