{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:45:56Z","timestamp":1791812756774,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Mutations in\n FLT3<\/jats:italic>\n are present in approximately 30% of patients with AML. The addition of midostaurin (MIDO) to intensive chemotherapy (IC) became standard of care following the RATIFY trial, but comprehensive real\u2010world data spanning the full adult age spectrum and including both\n FLT3<\/jats:italic>\n \u2010ITD and\n FLT3<\/jats:italic>\n \u2010TKD mutations remain limited. We retrospectively analyzed 1658 adults aged 14\u201385\u2009years with newly diagnosed\n FLT3<\/jats:italic>\n \u2010mutated AML from 129 PETHEMA registry centers: 469 received IC\u2009+\u2009MIDO and 1189 IC alone. Composite complete remission was higher with IC\u2009+\u2009MIDO than IC (81.4% vs. 71.7%;\n p<\/jats:italic>\n \u2009<\u20090.001) and Day 30 mortality was substantially lower (2.1% vs. 7.1%;\n p<\/jats:italic>\n \u2009<\u20090.001). Median overall survival was 47.2 versus 19.3\u2009months (HR 0.64; 95% CI, 0.53\u20130.76;\n p<\/jats:italic>\n \u2009<\u20090.001), and the benefit was sustained after multivariable adjustment (HR 0.73;\n p<\/jats:italic>\n \u2009=\u20090.017). In 261 propensity score\u2013matched pairs, the effect was attenuated, remaining significant for event\u2010free survival (HR 0.77;\n p<\/jats:italic>\n \u2009=\u20090.029) and showing a nonsignificant trend for OS (HR 0.77;\n p<\/jats:italic>\n \u2009=\u20090.06). Allogeneic hematopoietic stem cell transplantation in first remission was more frequent in the IC\u2009+\u2009MIDO cohort (48.9% vs. 41.3%;\n p<\/jats:italic>\n \u2009=\u20090.023). Time\u2010dependent analyses showed the largest MIDO effect among autologous and non\u2010transplanted patients (OS HR 0.45;\n p<\/jats:italic>\n \u2009=\u20090.138, and HR 0.69;\n p<\/jats:italic>\n \u2009=\u20090.014, respectively). The benefit of MIDO was consistent irrespective of\n FLT3<\/jats:italic>\n mutation type,\n FLT3<\/jats:italic>\n \u2010ITD allelic burden, cytogenetic risk, and gender, while less improvement occurred among\n NPM1<\/jats:italic>\n wild type and secondary AML patients. This large real\u2010world cohort confirms the survival benefit of MIDO plus IC across the full adult age spectrum, supporting its standard\u2010of\u2010care status in\n FLT3<\/jats:italic>\n \u2010mutated AML.\n <\/jats:p>","DOI":"10.1002\/ajh.70488","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:40:26Z","timestamp":1788180026000},"page":"2812-2826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Outcomes of Midostaurin Plus Intensive Chemotherapy in\n FLT3<\/i>\n \u2010Mutated AML: The\u00a0PETHRATIFY Study"],"prefix":"10.1002","volume":"101","author":[{"given":"M\u00f3nica Alejandra","family":"Romero Riquelme","sequence":"first","affiliation":[{"name":"Hospital Guillermo Grant Benavente de Concepci\u00f3n Concepci\u00f3n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9033-575X","authenticated-orcid":false,"given":"Gaspar","family":"Aspas Requena","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital of Montpellier Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Lloret\u2010Madrid","sequence":"additional","affiliation":[{"name":"Hospital Universitario y Polit\u00e9cnico La Fe Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5062-2364","authenticated-orcid":false,"given":"Cristina","family":"Gil","sequence":"additional","affiliation":[{"name":"Hospital General Universitario de Alicante Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-419X","authenticated-orcid":false,"given":"Eliana","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Centro Hospitalar S\u00e3o Jo\u00e3o Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-1649","authenticated-orcid":false,"given":"Mar","family":"Tormo","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2338-513X","authenticated-orcid":false,"given":"Teresa","family":"del Bernal del Castillo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Central de Asturias Oviedo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2237-6733","authenticated-orcid":false,"given":"Eduardo","family":"Rodr\u00edguez Arbol\u00ed","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7046-8722","authenticated-orcid":false,"given":"Josefina","family":"Serrano","sequence":"additional","affiliation":[{"name":"Hospital Universitario Reina Sof\u00eda C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"S\u00e1nchez\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hospital Universitario Reina Sof\u00eda C\u00f3rdoba Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Rodr\u00edguez\u2010Medina","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Gran 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