Acute myeloid leukemia treatment adapts to genetic traits to lower relapse rates

For patients diagnosed with acute myeloid leukemia (AML), a type of cancer where white blood cells grow rapidly, treatment strategies are increasingly tailored to the specific genetic characteristics of their disease. This personalized approach is crucial, especially for those with a particular genetic mutation known as FLT3-ITD.

This mutation, present in approximately one in four adult AML patients, significantly increases the risk of relapse and accelerates the disease's progression, often leading to poorer treatment outcomes. "AML is a representative blood cancer where the latest treatment strategies vary depending on genetic characteristics," explained Dr. Ahn Jae-sook, a professor of hematology at Hwasun Chonnam National University Hospital. "In particular, the FLT3-ITD mutation, found in about one in four AML patients, has a high risk of recurrence and rapid progression, making treatment results unfavorable. Therefore, it is important to identify the presence and type of FLT3 mutation early on to establish an appropriate treatment strategy."

Traditionally, AML treatment begins with intensive chemotherapy to reduce cancer cells, followed by consolidation therapy to prevent recurrence. For high-risk patients, such as those with the FLT3-ITD mutation, maintenance therapy is also emphasized to prolong remission. However, even with existing targeted therapies combined with chemotherapy, the cumulative relapse rate within two years remained around 40%, with a significant portion of these being FLT3-ITD positive patients.

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AML is a representative blood cancer where the latest treatment strategies vary depending on genetic characteristics. In particular, the FLT3-ITD mutation, found in about one in four AML patients, has a high risk of recurrence and rapid progression, making treatment results unfavorable. Therefore, it is important to identify the presence and type of FLT3 mutation early on to establish an appropriate treatment strategy.

The landscape is shifting with the advent of second-generation FLT3 inhibitors. Quizartinib, a drug specifically designed to target FLT3-ITD mutations, has received approval in South Korea. It is currently the only available treatment for newly diagnosed adult AML patients with this mutation, applicable across induction, consolidation, and maintenance therapies. Clinical studies show quizartinib reduced the risk of death by 22% compared to a placebo and extended remission duration threefold, while also lowering relapse risk. The U.S. National Comprehensive Cancer Network also recommends it as a standard treatment strategy.

"Because FLT3-ITD mutations carry a high risk of recurrence, treatment strategies to reduce recurrence after initial therapy are important," Dr. Ahn stated. "With the emergence of next-generation therapies targeting FLT3-ITD (quizartinib), an option applicable from initial treatment to maintenance therapy has been established. We expect the prognosis for AML patients with FLT3-ITD mutations to improve through customized treatment based on accurate genetic diagnosis."

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Because FLT3-ITD mutations carry a high risk of recurrence, treatment strategies to reduce recurrence after initial therapy are important. With the emergence of next-generation therapies targeting FLT3-ITD (quizartinib), an option applicable from initial treatment to maintenance therapy has been established. We expect the prognosis for AML patients with FLT3-ITD mutations to improve through customized treatment based on accurate genetic diagnosis.