FLT3 mutation

FLT3 is a gene change, or mutation, in leukemia (blood cancer) cells. It’s the most common genetic change in acute myeloid leukemia (AML), a type of leukemia that starts in the bone marrow and often moves into the blood.

The FLT3 gene helps white blood cells grow. Too many white blood cells are encouraged by a variation in this gene.

There are two types of this.

  • FLT3-ITD: involving multiple copies of the gene in a row
  • FLT3-TKD: involving a single change or gene deletions

People with the FLT3 mutation have a very aggressive form of leukemia that’s more likely to return after it’s treated. Around 20 percent of people with AML have the FLT3-ITD mutation, while 10 percent have FLT3-TKD.

The FLT3 mutation was not very effective against cancers in the past. New drugs that target thismutation are improving the outlook for people with this type of leukemia.

The cancer cells look different depending on what genes are changed. Some types ofAML, including those with the FLT3 mutation, need different treatment.

The FLT3 is a gene that regulates cell survival. The blood cells are affected by the genemutation.

As a result, people with the FLT3 mutation have a less promising outlook compared with other types of AML. Their disease is more likely to return, or relapse, after treatment. They also tend to have a lower survival rate than people without the mutation.

Acute Myeloid Leukemia causes symptoms quickly. These symptoms may include some.

These symptoms are usually caused by another condition. If you have any symptoms of the disease, it is important to talk with your doctor.

FLT3 mutations occur more often in people under 60 years old.

Other risk factors for AML include:

The College of American Pathologists and the American Society of Hematology recommend that everyone who is diagnosed with AML gets tested for the FLT3 gene mutation.

Your doctor will have you tested in a number of ways.

  • Blood test. Blood is drawn from a vein in your arm and sent to a lab.
  • Bone marrow aspiration or biopsy. A needle is inserted into your bone. The needle removes a small amount of liquid bone marrow.

If you have the FLT3 mutation in your leukemia cells, the blood or bone marrow sample will be tested to see if it is still present. This test will show you if you are a good candidate for drugs that target this type of leukemia.

Until recently, people with the FLT3 mutation were mainly treated with chemotherapy, which wasn’t very effective at improving survival rates. A new group of drugs called FLT3 inhibitors is improving the outlook for people with the mutation. Researchers are also investigating other treatments for the condition.

FLT3 inhibitors

The FLT3 inhibitor midostaurin (Rydapt) was the first drug approved for FLT3, and the first new drug approved to treat AML in over 15 years. Doctors give midostaurin together with chemotherapy drugs such as cytarabine and daunorubicin.

FLT3 and other proteins help leukemia cells grow. You take it by mouth twice a day.

A 2017 study involving 717 people with the FLT3 gene published in The New England Journal of Medicine looked at the effects of treatment with this new drug. Researchers found that adding midostaurin to chemotherapy prolonged survival compared with an inactive treatment (placebo) plus chemotherapy.

The 4-year survival rate was 51 percent among people who took midostaurin, compared with just over 44 percent in the placebo group. The median length of survival (the point at which half of the participants were still alive) was more than 6 years in the treatment group, versus just over 2 years in the placebo group.

The group that received midostaurin had higher rates of rash and anemia than the group that received a placebo.

Midostaurin is given in combination with chemotherapy. Other possible side effects of the treatment include:

  • There is a high degree of fever. and low white blood cells (febrile neutropenia)
  • nausea
  • vomiting
  • There are sores in the mouth.
  • There are There are headaches..
  • muscle or bone pain
  • There are There are nosebleeds..
  • high levels of sugar in the blood

Your doctor will monitor you for side effects while you are on this drug and offer you treatments to help manage them.

The FLT3 is a first-generation drug. FLT3 is more specifically and powerfully targeted by second- generation FLT3 inhibitors.

In 2018, the FDA approved the second-generation FLT3 inhibitor gilteritinib (Xospata) for people with relapsed AML with FLT3 mutation. Clinical trials for the drug found that those who received it lived longer and had a higher chance of achieving remission compared with those who received chemotherapy.

Clinical trials are still being conducted to see if crenolanib and quizartinib work.

Other treatments

Your doctor may recommend a stem cell transplant if you have FLT3-mutated AML that’s in remission (decreased symptoms). It uses stem cells either from a donor or from your body (in which case they’ll have been treated to kill leukemia cells) and then injects them into your blood. This may reduce the chance of the cancer returning.

Researchers are looking at whether different combinations of drugs might be more effective in people with this genetic abnormality.

If you have the FLT3 mutation, you are more likely to have a less positive outcome. FLT3 inhibitors are helping improve the outlook. New drugs and combinations of drugs may prolong survival even more.

If you are diagnosed with leukemia, your doctor will test you for FLT3 and other genes. Knowing as much as possible about your condition can help your doctor find the best treatment for you.