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EBMT 2021 | FLT3 inhibitor maintenance after allo-SCT for AML

Nicolaus Kröger, MD, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, gives an overview of novel maintenance strategies for patients with acute myeloid leukemia (AML) who undergo allogeneic stem cell transplantation (allo-SCT). Prof. Kröger reports that prospective studies have demonstrated that maintenance therapy with FLT3 inhibitors benefits patients with AML who have FLT3 mutations. Prof. Kröger also highlights the potential of IDH inhibitors, donor lymphocyte infusion, and other cellular therapies which are currently under investigation to reduce the risk of relapse after allo-SCT. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.

Transcript (edited for clarity)

Relapse is still the major cause of treatment failure after allogeneic stem cell transplantation for many disease, but also for acute myeloid leukemia, which is the most frequently used indication for allogeneic stem cell transplantation.

So, in the last 20 years, there has been major progress in reducing non-relapse mortality. However, the relapse incidence remains still pretty high. So, in the last 10 years, there were many efforts done, more biological, but also on the clinical side to improve outcome regarding stem cell transplantation, especially with respect to relapse...

Relapse is still the major cause of treatment failure after allogeneic stem cell transplantation for many disease, but also for acute myeloid leukemia, which is the most frequently used indication for allogeneic stem cell transplantation.

So, in the last 20 years, there has been major progress in reducing non-relapse mortality. However, the relapse incidence remains still pretty high. So, in the last 10 years, there were many efforts done, more biological, but also on the clinical side to improve outcome regarding stem cell transplantation, especially with respect to relapse.

So, several issues to include maintenance therapy have been proposed and are conducted. So, currently prospective studies has shown there is a benefit for FLT3 inhibitor, for FLT3 inhibitors in FLT3 positive leukemia patients. In randomized studies this has been shown by a large Chinese and also by a German study.

And also, the next generation of TKIs FLT3 inhibitors are currently in clinical studies to get approval as maintenance. But also, other molecule marker like IDH, IDH inhibitors, and others donor lymphocyte infusion, and also other cellular therapy are currently investigated to reduce the risk of relapse. This is an exciting new field in the field of transplantation. And the preliminary results we have so far the preliminary results, looks very very encouraging.

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