Гилтеритиниб — новая возможность в лечении рецидивов и рефрактерных острых миелоидных лейкозов с мутацией в гене FLT3: обзор литературы и описание трех собственных клинических наблюдений

Abstract

Acute myeloid leukemias (AML) are the most ubiquitous of all adult leukemias. The prognosis of the disease depends on its genetic profile. The mutation in FLT3 gene, which codes FMS-like tyrosine kinase 3, is observed in 1/3 of patients and is responsible for a high rate of relapses. The prognosis of relapsed/refractory FLT3-positive AML is extremely poor. The standard intensive therapy rarely yields long-term responses. The new first- and second-generation FLT3 tyrosine kinase inhibitors enriched treatment opportunities for patients with this mutation. Gilteritinib, a potent second-generation FLT3-ITD/TKD inhibitor, is a new effective and well tolerated drug for the treatment of relapsed/refractory FLT3-positive AML. Due to its efficacy, low toxicity, and good manageability, this drug can be administered to all patients, including the elderly or those with severe comorbidities and complications of previous therapy. Besides, this drug can be used in outpatient units. The present paper contains three case reports dealing with different clinical situations in patients with FLT3-positive AML treated with gilteritinib in real-world clinical practice.