Hosono Naoko
Department of Blood Transfusion, University of Fukui Hospital.
Rinsho Ketsueki. 2022;63(9):1242-1251. doi: 10.11406/rinketsu.63.1242.
FMS-like tyrosine kinase 3 (FLT3) mutations are observed in 25-30% of patients with acute myeloid leukemia (AML). Due to poor prognosis associated with FLT3-mutated AML, allogeneic hematopoietic transplantation is commonly performed to induce remission. With the availability of active FLT3 inhibitors and improvement in transplants techniques, the outcomes of AML have improved drastically. The results of many clinical trials have shown that FLT3 inhibitors in combination with chemotherapy and post-transplant maintenance therapy are most effective for AML. Furthermore, these developments have opened up the possibility of transplantation for elderly patients in whom transplantation is difficult. Here, we discuss the optimal approach for treating FLT3-mutated AML using FLT3 inhibitors, allogenic transplantation, and post-transplant maintenance therapy.
在25%-30%的急性髓系白血病(AML)患者中可观察到FMS样酪氨酸激酶3(FLT3)突变。由于FLT3突变型AML预后较差,通常会进行异基因造血移植以诱导缓解。随着活性FLT3抑制剂的出现以及移植技术的改进,AML的治疗效果有了显著改善。许多临床试验结果表明,FLT3抑制剂联合化疗及移植后维持治疗对AML最为有效。此外,这些进展为移植困难的老年患者带来了移植的可能性。在此,我们讨论使用FLT3抑制剂、异基因移植及移植后维持治疗来治疗FLT3突变型AML的最佳方法。