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EHA 2026 | Post-transplant FLT3 inhibitor maintenance in AML: evidence and practical considerations
Robert Negrin, MD, Stanford University, Stanford, CA, discusses the growing role of FLT3 inhibitor maintenance therapy following allogeneic stem cell transplantation in FLT3-mutated acute myeloid leukemia (AML). Prof. Negrin reviews the evidence supporting post-transplant maintenance, particularly with gilteritinib, and discusses key considerations including toxicity management, patient selection, treatment duration, and molecular monitoring using PCR-based assays to detect relapse risk. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Yes, so the use of FLT3 inhibitors following transplant is, in our practice, a standard approach based upon several different studies that show benefit for these patients that receive maintenance therapy, mainly again with gilteritinib. Some of the other agents are coming along as well. A lot of it has to do with toxicity concerns, how well these are tolerated. The duration of therapy is a controversial topic...
Yes, so the use of FLT3 inhibitors following transplant is, in our practice, a standard approach based upon several different studies that show benefit for these patients that receive maintenance therapy, mainly again with gilteritinib. Some of the other agents are coming along as well. A lot of it has to do with toxicity concerns, how well these are tolerated. The duration of therapy is a controversial topic. In our practice, generally, we continue for two years following transplant, assuming that the patients tolerate these therapies. And we do monitor these patients with PCR-based assays looking for the mutation. And those that we find that are FLT3 negative, in some situations we may consider stopping early, mainly due to toxicity concerns. That’s the major issue that our patients are facing.
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