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Purpose of Review <p>Younger patients with acute myeloblastic leukemia with <i>FLT3</i> mutations (<i>FLT3</i>-mutated AML) benefit from the addition of FLT3 inhibitors to intensive chemotherapy. However, patients who are not eligible for intensive chemotherapy have poor outcomes with standard low-intensity treatments. In this review we assess the current state of treatment strategies for patients with <i>FLT3</i>-mutated AML who are not candidates for intensive chemotherapy.</p> Recent Findings <p>The addition of FLT3 inhibitors to standard low-intensity AML treatments (doublet) has increased response rates, although in a randomized clinical trial this did not improve survival. The addition of venetoclax to these regimens (triplet) shows promising activity (overall response rate of approximately 90%). However, myelotoxicity is common, and dose adjustments are usually necessary.</p> Summary <p>Combinations of low-intensity treatments with venetoclax and potent FLT3 inhibitors are feasible and have shown encouraging outcomes. Dose adjustments are essential to reduce treatment-related myelosuppression.</p>

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Current Treatment Strategies for FLT3-Mutated Acute Myeloid Leukemia in Patients not Candidates for Intensive Chemotherapy

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Alex Bataller,
  • Nicholas J. Short,
  • Naval Daver,
  • Musa Yilmaz,
  • Hagop Kantarjian,
  • Farhad Ravandi

摘要

Purpose of Review

Younger patients with acute myeloblastic leukemia with FLT3 mutations (FLT3-mutated AML) benefit from the addition of FLT3 inhibitors to intensive chemotherapy. However, patients who are not eligible for intensive chemotherapy have poor outcomes with standard low-intensity treatments. In this review we assess the current state of treatment strategies for patients with FLT3-mutated AML who are not candidates for intensive chemotherapy.

Recent Findings

The addition of FLT3 inhibitors to standard low-intensity AML treatments (doublet) has increased response rates, although in a randomized clinical trial this did not improve survival. The addition of venetoclax to these regimens (triplet) shows promising activity (overall response rate of approximately 90%). However, myelotoxicity is common, and dose adjustments are usually necessary.

Summary

Combinations of low-intensity treatments with venetoclax and potent FLT3 inhibitors are feasible and have shown encouraging outcomes. Dose adjustments are essential to reduce treatment-related myelosuppression.