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This document presents data on the outcomes and toxicities of a treatment regimen for older adults with newly diagnosed FLT3-mutated acute myeloid leukemia (AML). The study found that the treatment approach, which included induction chemotherapy with the addition of midostaurin, resulted in a high complete remission rate and a median overall survival of 9.3 months. Additionally, a significant number of patients underwent allogeneic hematopoietic stem cell transplantation (allo-HCT) with favorable outcomes. The authors conclude that this treatment approach is feasible and effective for older adults with FLT3-mutated AML. However, the study lacked long-term follow-up and data on minimal residual disease achievement and allo-HCT outcomes. [Extracted from the article]

Relapsed or refractory (R/R) acute myeloid leukemia (AML) with FMS-like tyrosine kinase 3 (FLT3) mutations remains a difficult and hard to treat entity. Gilteritinib is a potent oral FLT-3 inhibitor that improves overall survival in R/R AML, but studies are limited in combining gilteritinib with a hypomethylating agent and venetoclax treatment backbone (HMA-VEN-GILT). Here we report our experience with HMA-VEN-GILT for 22 R/R FLT3 AML patients. HMA-VEN-GILT yielded an ORR of 77.3% (17/22), CR 4.5% (1/22), CRi 13.6% (3/22), MLFS 59.1% (13/22). Median follow-up was 10.4 months with a relapse rate of 29.4% (5/17), median time to relapse of 69 days (range 35–298 days), 6-month overall survival of 84%, and median OS of 10.1 months. Additionally, 36.4% (8/22) of patients proceeded to hematopoietic stem cell transplant. In conclusion, HMA-VEN-GILT for the treatment of R/R FLT3 AML is feasible and can be used as a bridge to allogeneic transplantation. [ABSTRACT FROM AUTHOR]

Background: Studies have suggested that acute myeloid leukemia (AML) patients with incomplete hematologic recovery undergoing allogeneic stem cell transplantation (allo‐HSCT) had inferior overall survival (OS). Study Design and Methods: This single‐center, retrospective study of AML patients evaluated the relationship between red blood cell (RBC) and platelet (PLT) transfusion requirements during the first 30 days and long‐term outcomes after allo‐HSCT through multivariate analyses. Results: A total of 692 AML patients received peripheral blood stem cells (89.2%), marrow (5.6%), or umbilical cord (5.2%) from matched related (37.4%), unrelated (49.1%), or haploidentical (8.2%) donors in 2011–2017. Transfusion requirements during the first 30 days for RBC (89.5% transfused, median 3, range 1–18 units) or PLT (98.2% transfused, median 6, range 1–144 units) were variable. By Day 30, 56.7% (95% confidence interval [CI]: 52.8–60.3%) and 86.1% (95% CI: 83.2–88.5%) had achieved RBC and PLT transfusion independence, respectively. Median follow‐up among survivors (n = 307) was 7.1 years (range: 2.7–11.8). Lack of RBC transfusion independence by Day 30 was strongly and independently associated with worse 5‐year OS (39.2% vs. 59.6%, adjusted hazard ratio [HR] 1.83, 95% CI: 1.49–2.25), leukemia‐free survival (35.8% vs. 55.5%, HR = 1.75, 95% CI: 1.43–2.14), and NRM (29.7% vs. 13.7%, HR = 2.05, 95% CI: 1.45–2.89) (p <.001). There was no difference in relapse rates among patients who achieved or did not achieve RBC (p =.34) or PLT (p =.64) transfusion independence. Conclusion: Prolonged RBC dependence predicted worse survival and NRM rates, but not increased relapse. Posttransplant surveillance of such patients should be adjusted with more attention to non‐relapse complications. [ABSTRACT FROM AUTHOR]