Blackmon Amanda, Aldoss Ibrahim, Ball Brian J
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA.
Blood Lymphat Cancer. 2022 Sep 6;12:137-147. doi: 10.2147/BLCTT.S281252. eCollection 2022.
Mutations in the gene are associated with poor prognosis in patients with AML, even after consolidation with allogeneic hematopoietic cell transplantation (alloHCT) in first remission. Treatment failure in -mutated AML is largely driven by excessive risk of relapse compared to other genetic subtypes, including in patients post-alloHCT. As a result, there is substantial interest in studying posttransplant maintenance therapy in -mutated AML as an approach to optimize disease control and improve long-term outcomes. Clinical trials utilizing posttransplant FLT3 inhibitors, such as sorafenib and midostaurin, have shown feasibility, safety, and encouraging posttransplant outcomes, and there are ongoing studies using newer-generation tyrosine-kinase inhibitors as posttransplant maintenance therapy. Here, we review the toxicities and efficacy of FLT3 inhibitors as posttransplant maintenance, recommendations on the use of FLT3 inhibitors by international consensus guidelines, and highlight key remaining questions.
该基因的突变与急性髓系白血病（AML）患者的不良预后相关，即使在首次缓解期接受异基因造血细胞移植（alloHCT）巩固治疗后也是如此。与其他基因亚型相比，包括alloHCT后的患者，FLT3突变的AML治疗失败主要是由复发风险过高所致。因此，作为优化疾病控制和改善长期预后的一种方法，对研究FLT3突变的AML移植后维持治疗有很大兴趣。使用移植后FLT3抑制剂（如索拉非尼和米哚妥林）的临床试验已显示出可行性、安全性，并取得了令人鼓舞的移植后结果，并且正在进行使用新一代酪氨酸激酶抑制剂作为移植后维持治疗的研究。在此，我们综述了FLT3抑制剂作为移植后维持治疗的毒性和疗效、国际共识指南对使用FLT3抑制剂的建议，并强调了仍然存在的关键问题。
