{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:44Z","timestamp":1787027804513,"version":"build-2736575974"},"reference-count":79,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Astellas"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: The emergence of FLT3 inhibitors (FLT3i) has radically transformed the prognostic and therapeutic landscape for FLT3-mutated Acute Myeloid Leukemia, stimulating the need for comprehensive and structured clinical guidance. Methods: We aimed to develop evidence-based recommendations spanning the entire disease continuum of FLT3-mutated AML from leading Italian experts through a modified Delphi consensus process. Results: The panel achieved a high degree of agreement on specific interventions covering diagnostic testing, upfront FLT3i integration, role of allogeneic hematopoietic cell transplantation (allo-HSCT), Minimal Residual Disease (MRD) monitoring, and relapsed\/refractory (R\/R) strategies. Key recommendations mandate that analysis for both FLT3-ITD and FLT3-TKD mutations is required at diagnosis, with capillary electrophoresis or NGS as preferred methods. All fit patients with FLT3m-AML must receive intensive chemotherapy plus a FLT3i (midostaurin or quizartinib) and be evaluated for allo-HSCT. For unfit patients, the current standard of HMA + venetoclax is considered suboptimal, making the search for alternative strategies imperative. MRD monitoring using available molecular or flow cytometry markers is recommended to assess relapse risk and to optimize the allo-HSCT strategy. In the R\/R setting, retesting the FLT3 status is mandatory, and gilteritinib is the standard treatment, serving as a bridge-to-transplant and for post-HSCT maintenance. Conclusions: The integration of FLT3i has shifted FLT3m-AML into a more favorable intermediate prognostic category, enhancing the role of curative strategies like allo-HSCT. This consensus paper provides a structured evidence-based comprehensive guide, translating complex data into clear actionable clinical recommendations that minimize practice variability and ultimately optimize management for this high-risk population.<\/jats:p>","DOI":"10.3390\/cancers18050770","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:05:16Z","timestamp":1772211916000},"page":"770","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Modified-Delphi Consensus on the Management of Patients with FLT3-Mutated AML"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2582-3500","authenticated-orcid":false,"given":"Jacopo","family":"Olivieri","sequence":"first","affiliation":[{"name":"Hematology Clinic and Cellular Therapy Center, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-6080","authenticated-orcid":false,"given":"Emanuele","family":"Angelucci","sequence":"additional","affiliation":[{"name":"Hematology and Cellular Therapy Unit, IRCCS San Martino Hospital, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-2623","authenticated-orcid":false,"given":"Roberto","family":"Cairoli","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Molecular Medicine, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9139-1729","authenticated-orcid":false,"given":"Maria Paola","family":"Martelli","sequence":"additional","affiliation":[{"name":"Hematology and Clinical Immunology Section, Center for Hemato-Oncology Research, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy"},{"name":"Hematology Division, \u2018Santa Maria della Misericordia\u2019 Hospital, Azienda Ospedaliera di Perugia, 06156 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3987-419X","authenticated-orcid":false,"given":"Massimo","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplantation and Cellular Therapies Unit (CTMO), Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, 89133 Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Papayannidis","sequence":"additional","affiliation":[{"name":"Hematology Institute Ser\u00e0gnoli, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40100 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-3465","authenticated-orcid":false,"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, 20123 Rome, Italy"},{"name":"Department of Laboratory and Hematological Sciences, Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6164-4761","authenticated-orcid":false,"given":"Maria Teresa","family":"Voso","sequence":"additional","affiliation":[{"name":"Onco-Hematology Advanced Diagnostics UOSD, Policlinico Universitario Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0245-0553","authenticated-orcid":false,"given":"Adriano","family":"Venditti","sequence":"additional","affiliation":[{"name":"Onco-Hematology Department, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1200\/JCO.2016.71.2208","article-title":"Genomics of Acute Myeloid Leukemia Diagnosis and Pathways","volume":"35","author":"Bullinger","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1056\/NEJMoa1516192","article-title":"Genomic Classification and Prognosis in Acute Myeloid Leukemia","volume":"374","author":"Papaemmanuil","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1038\/s41375-022-01650-w","article-title":"Genomic landscape of patients with FLT3-mutated acute myeloid leukemia (AML) treated within the CALGB 10603\/RATIFY trial","volume":"36","author":"Jahn","year":"2022","journal-title":"Leukemia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1182\/blood-2007-05-091215","article-title":"Prognostic relevance of FLT3-TKD mutations in AML: The combination matters\u2014An analysis of 3082 patients","volume":"111","author":"Bacher","year":"2008","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1182\/blood-2016-08-733196","article-title":"Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel","volume":"129","author":"Dohner","year":"2017","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1182\/blood.2019002697","article-title":"Impact of NPM1\/FLT3-ITD genotypes defined by the 2017 European LeukemiaNet in patients with acute myeloid leukemia","volume":"135","author":"Dohner","year":"2020","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Capelli, D., Menotti, D., Fiorentini, A., Saraceni, F., and Olivieri, A. (2022). Overcoming Resistance: FLT3 Inhibitors Past, Present, Future and the Challenge of Cure. Cancers, 14.","DOI":"10.3390\/cancers14174315"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2834","DOI":"10.1182\/blood.2024024248","article-title":"Approaching a therapeutic inflection point for FLT3-mutated AML","volume":"145","author":"Perl","year":"2025","journal-title":"Blood"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN","volume":"140","author":"Dohner","year":"2022","journal-title":"Blood"},{"key":"ref_10","first-page":"2024","article-title":"Impact of hematopoietic cell transplantation and quizartinib in newly diagnosed patients with acute myeloid leukemia and FMS-like tyrosine kinase 3-internal tandem duplications in the QuANTUM-First trial","volume":"110","author":"Schlenk","year":"2025","journal-title":"Haematologica"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1056\/NEJMoa1614359","article-title":"Midostaurin plus Chemotherapy for Acute Myeloid Leukemia with a FLT3 Mutation","volume":"377","author":"Stone","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3366","DOI":"10.1182\/blood.2021011583","article-title":"Follow-up of patients with R\/R FLT3-mutation-positive AML treated with gilteritinib in the phase 3 ADMIRAL trial","volume":"139","author":"Perl","year":"2022","journal-title":"Blood"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S1470-2045(19)30150-0","article-title":"Quizartinib versus salvage chemotherapy in relapsed or refractory FLT3-ITD acute myeloid leukaemia (QuANTUM-R): A multicentre, randomised, controlled, open-label, phase 3 trial","volume":"20","author":"Cortes","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gattrell, W.T., Logullo, P., van Zuuren, E.J., Price, A., Hughes, E.L., Blazey, P., Winchester, C.C., Tovey, D., Goldman, K., and Hungin, A.P. (2024). ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med., 21.","DOI":"10.1371\/journal.pmed.1004326"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1182\/blood.2024025409","article-title":"Genetic risk classification for adults with AML receiving less-intensive therapies: The 2024 ELN recommendations","volume":"144","author":"Dohner","year":"2024","journal-title":"Blood"},{"key":"ref_16","unstructured":"SIES (2023). Diagnostica Avanzata Delle Leucemie Mieloidi Acute Dell\u2019adulto per un Corretto Inquadramento Prognostico: Linee-guida Della Societa\u2019 Italiana di Ematologia Sperimentale, SIES."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jmoldx.2012.08.001","article-title":"Detection of FLT3 internal tandem duplication in targeted, short-read-length, next-generation sequencing data","volume":"15","author":"Spencer","year":"2013","journal-title":"J. Mol. Diagn."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.jmoldx.2021.07.012","article-title":"Accurate Detection and Quantification of FLT3 Internal Tandem Duplications in Clinical Hybrid Capture Next-Generation Sequencing Data","volume":"23","author":"Tung","year":"2021","journal-title":"J. Mol. Diagn."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.1038\/s41375-019-0483-z","article-title":"getITD for FLT3-ITD-based MRD monitoring in AML","volume":"33","author":"Blatte","year":"2019","journal-title":"Leukemia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1182\/bloodadvances.2018015925","article-title":"A next-generation sequencing-based assay for minimal residual disease assessment in AML patients with FLT3-ITD mutations","volume":"2","author":"Levis","year":"2018","journal-title":"Blood Adv."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Li, S., Li, N., Chen, Y., Zheng, Z., and Guo, Y. (2023). FLT3-TKD in the prognosis of patients with acute myeloid leukemia: A meta-analysis. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1086846"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e545","DOI":"10.1016\/j.clml.2018.06.006","article-title":"FLT3-TKD Mutations Associated With NPM1 Mutations Define a Favorable-risk Group in Patients With Acute Myeloid Leukemia","volume":"18","author":"Perry","year":"2018","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4945","DOI":"10.1182\/bloodadvances.2020002904","article-title":"Midostaurin in patients with acute myeloid leukemia and FLT3-TKD mutations: A subanalysis from the RATIFY trial","volume":"4","author":"Voso","year":"2020","journal-title":"Blood Adv."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Stone, J., Mandrekar, S.J., and Sanford, B.L. (2024, January 7\u201310). 10 year follow-up of CALGB 10603\/Ratify: Midostaurin versus placebo plus intensive chemotherapy in newly diagnosed FLT3 mutant acute myeloid leukemia patients aged 18-60 years. Proceedings of the 66th American Society of Hematology Annual Meeting and Exposition, San Diego, CA, USA.","DOI":"10.1182\/blood-2024-201058"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/S0140-6736(23)00464-6","article-title":"Quizartinib plus chemotherapy in newly diagnosed patients with FLT3-internal-tandem-duplication-positive acute myeloid leukaemia (QuANTUM-First): A randomised, double-blind, placebo-controlled, phase 3 trial","volume":"401","author":"Erba","year":"2023","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4236","DOI":"10.1200\/JCO.22.02721","article-title":"Gilteritinib in Combination With Induction and Consolidation Chemotherapy and as Maintenance Therapy: A Phase IB Study in Patients With Newly Diagnosed AML","volume":"41","author":"Pratz","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1182\/blood-2024-201595","article-title":"Gilteritinib Results in Higher Remission and Transplant Rates Than Midostaurin but Does Not Increase the Post-Induction Mutational MRD Negative Rate: Results of the Phase 2 Randomized Precog 0905 Study in Newly Diagnosed FLT3 Mutated AML","volume":"144","author":"Luger","year":"2024","journal-title":"Blood"},{"key":"ref_28","unstructured":"HOVON (2025, November 15). HOVON HO156 AML. Available online: https:\/\/hovon.nl\/en\/trials\/ho156."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1002\/jha2.1045","article-title":"A GIMEMA survey on therapeutic use and response rates of FLT3 inhibitors in acute myeloid leukemia: Insights from Italian real-world practice","volume":"5","author":"Messina","year":"2024","journal-title":"EJHaem"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/ajh.27547","article-title":"Efficacy of Midostaurin Combined With Intensive Chemotherapy in Core Binding Factor Leukemia: A Phase II Clinical Trial","volume":"100","author":"Cairoli","year":"2025","journal-title":"Am. J. Hematol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"836","DOI":"10.3324\/haematol.2021.278645","article-title":"Characteristics and outcome of patients with core-binding factor acute myeloid leukemia and FLT3-ITD: Results from an international collaborative study","volume":"107","author":"Kayser","year":"2022","journal-title":"Haematologica"},{"key":"ref_32","first-page":"1903","article-title":"It takes two to tango: Allogeneic stem cell transplantation and FLT3 tyrosine kinase inhibitor therapy","volume":"110","author":"Cornelissen","year":"2025","journal-title":"Haematologica"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e35813","DOI":"10.1002\/cncr.35813","article-title":"A retrospective study of outcomes across time and treatment regimens in newly diagnosed, FMS-like tyrosine kinase 3 (FLT3)-mutated acute myeloid leukemia","volume":"131","author":"Bazinet","year":"2025","journal-title":"Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.bbmt.2011.02.003","article-title":"Role of allogeneic transplantation for FLT3\/ITD acute myeloid leukemia: Outcomes from 133 consecutive newly diagnosed patients from a single institution","volume":"17","author":"DeZern","year":"2011","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1182\/blood.2023023096","article-title":"Postinduction molecular MRD identifies patients with NPM1 AML who benefit from allogeneic transplant in first remission","volume":"143","author":"Othman","year":"2024","journal-title":"Blood"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1182\/blood.2024024944","article-title":"Genetic risk stratification and outcomes among treatment-naive patients with AML treated with venetoclax and azacitidine","volume":"144","author":"Dohner","year":"2024","journal-title":"Blood"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1038\/s41408-022-00670-0","article-title":"Hypomethylating agent and venetoclax with FLT3 inhibitor \u201ctriplet\u201d therapy in older\/unfit patients with FLT3 mutated AML","volume":"12","author":"Yilmaz","year":"2022","journal-title":"Blood Cancer J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1200\/JCO.23.01911","article-title":"Azacitidine, Venetoclax, and Gilteritinib in Newly Diagnosed and Relapsed or Refractory FLT3-Mutated AML","volume":"42","author":"Short","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMoa2012971","article-title":"Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia","volume":"383","author":"DiNardo","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1182\/blood-2018-08-868752","article-title":"Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia","volume":"133","author":"DiNardo","year":"2019","journal-title":"Blood"},{"key":"ref_41","unstructured":"Yilmaz, M. (2024, January 7\u201310). Phase I\/II study of quizartinib, venetoclax, and decitabine triple combination in FLT3-ITD mutated AML. Proceedings of the 66th ASH Annual Meeting, San Diego, CA, USA."},{"key":"ref_42","unstructured":"Clinicaltria.gov (2025, November 15). Gilteritinib in Combination with Venetoclax and Azacitidine for AML Patients With FLT3 Mutations Ineligible for Intensive Treatment (SEQUENCE), Available online: https:\/\/clinicaltrials.gov\/study\/NCT06696183."},{"key":"ref_43","unstructured":"Clinicaltrial.gov (2025, November 15). A Study of Gilteritinib, Venetoclax and Azacitidine as a Combined Treatment for People Newly Diagnosed with Acute Myeloid Leukemia, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05520567."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6441","DOI":"10.1182\/bloodadvances.2023009847","article-title":"Midostaurin plus daunorubicin or idarubicin for young and older adults with FLT3-mutated AML: A phase 3b trial","volume":"7","author":"Sierra","year":"2023","journal-title":"Blood Adv."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2753","DOI":"10.1182\/blood.2021013626","article-title":"2021 Update on MRD in acute myeloid leukemia: A consensus document from the European LeukemiaNet MRD Working Party","volume":"138","author":"Heuser","year":"2021","journal-title":"Blood"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1200\/JCO.22.00715","article-title":"Prognostic Value of FLT3-Internal Tandem Duplication Residual Disease in Acute Myeloid Leukemia","volume":"41","author":"Grob","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1182\/blood.2024025154","article-title":"Measurable residual disease and posttransplantation gilteritinib maintenance for patients with FLT3-ITD-mutated AML","volume":"145","author":"Levis","year":"2025","journal-title":"Blood"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1001\/jamaoncol.2024.0985","article-title":"Measurable Residual FLT3 Internal Tandem Duplication Before Allogeneic Transplant for Acute Myeloid Leukemia","volume":"10","author":"Dillon","year":"2024","journal-title":"JAMA Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1056\/NEJMoa1716863","article-title":"Molecular Minimal Residual Disease in Acute Myeloid Leukemia","volume":"378","author":"Grob","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1001\/jamaoncol.2020.4600","article-title":"Association of Measurable Residual Disease With Survival Outcomes in Patients With Acute Myeloid Leukemia: A Systematic Review and Meta-analysis","volume":"6","author":"Short","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e346","DOI":"10.1016\/S2352-3026(25)00037-7","article-title":"Molecular monitoring versus standard clinical care in younger adults with acute myeloid leukaemia: Results from the UK NCRI AML17 and AML19 randomised, controlled, phase 3 trials","volume":"12","author":"Potter","year":"2025","journal-title":"Lancet Haematol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1182\/blood.2018886960","article-title":"GIMEMA AML1310 trial of risk-adapted, MRD-directed therapy for young adults with newly diagnosed acute myeloid leukemia","volume":"134","author":"Venditti","year":"2019","journal-title":"Blood"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e586","DOI":"10.1016\/S1470-2045(25)00426-7","article-title":"Measurable residual disease-guided interventions in patients with acute myeloid leukaemia undergoing allogeneic haematopoietic cell transplantation: Best practice recommendations from the European Society for Blood and Marrow Transplantation Practice Harmonisation and Guidelines Committee","volume":"26","author":"Sanz","year":"2025","journal-title":"Lancet Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1200\/JCO.19.03011","article-title":"Impact of Conditioning Intensity of Allogeneic Transplantation for Acute Myeloid Leukemia with Genomic Evidence of Residual Disease","volume":"38","author":"Hourigan","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"5123","DOI":"10.1182\/bloodadvances.2025016306","article-title":"Impact of transplant conditioning, NPM1 mutations, and measurable residual disease in FLT3-ITD acute myeloid leukemia","volume":"9","author":"Levis","year":"2025","journal-title":"Blood Adv."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s13045-017-0502-3","article-title":"Haploidentical allograft is superior to matched sibling donor allograft in eradicating pre-transplantation minimal residual disease of AML patients as determined by multiparameter flow cytometry: A retrospective and prospective analysis","volume":"10","author":"Chang","year":"2017","journal-title":"J. Hematol. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/ajh.25647","article-title":"Haploidentical transplantation for acute myeloid leukemia patients with minimal\/measurable residual disease at transplantation","volume":"94","author":"Srour","year":"2019","journal-title":"Am. J. Hematol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.3324\/haematol.2015.129650","article-title":"Efficacy of immune suppression tapering in treating relapse after reduced intensity allogeneic stem cell transplantation","volume":"100","author":"Kekre","year":"2015","journal-title":"Haematologica"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s00277-017-3204-6","article-title":"Early tapering of immunosuppressive agents after HLA-matched donor transplantation can improve the survival of patients with advanced acute myeloid leukemia","volume":"97","author":"Yang","year":"2018","journal-title":"Ann. Hematol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.bbmt.2016.03.005","article-title":"Wilms Tumor 1 Expression and Pre-emptive Immunotherapy in Patients with Acute Myeloid Leukemia Undergoing an Allogeneic Hemopoietic Stem Cell Transplantation","volume":"22","author":"Pozzi","year":"2016","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"5063","DOI":"10.1182\/blood-2007-02-072470","article-title":"Donor lymphocyte infusions for the treatment of minimal residual disease in acute leukemia","volume":"109","author":"Dominietto","year":"2007","journal-title":"Blood"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1038\/s41409-020-01174-w","article-title":"Pre-emptive use of Sorafenib combined with DLI post HSCT in AML FLT3+: A single center experience","volume":"56","author":"Bruzzese","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1056\/NEJMoa1902688","article-title":"Gilteritinib or Chemotherapy for Relapsed or Refractory FLT3-Mutated AML","volume":"381","author":"Perl","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"5590","DOI":"10.1182\/bloodadvances.2024014017","article-title":"Outcomes with single-agent gilteritinib for relapsed or refractory FLT3-mutant AML after contemporary induction therapy","volume":"8","author":"Othman","year":"2024","journal-title":"Blood Adv."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e70055","DOI":"10.1002\/cncr.70055","article-title":"Gilteritinib in FLT3-mutated acute myeloid leukemia: A real-world Italian experience","volume":"131","author":"Cairoli","year":"2025","journal-title":"Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1182\/bloodadvances.2019000174","article-title":"Gilteritinib: Potent targeting of FLT3 mutations in AML","volume":"4","author":"Levis","year":"2020","journal-title":"Blood Adv."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3093","DOI":"10.1182\/blood.2020007626","article-title":"Clonal evolution of acute myeloid leukemia with FLT3-ITD mutation under treatment with midostaurin","volume":"137","author":"Schmalbrock","year":"2021","journal-title":"Blood"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1002\/ajh.70053","article-title":"Cytomolecular Mechanisms of Relapse and Post-Relapse Outcomes After Frontline FLT3 Inhibitor-Based Therapy in FLT3 -Mutated AML","volume":"100","author":"Arora","year":"2025","journal-title":"Am. J. Hematol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3977","DOI":"10.1158\/1078-0432.CCR-14-3186","article-title":"A Leukemia-Associated CD34\/CD123\/CD25\/CD99+ Immunophenotype Identifies FLT3-Mutated Clones in Acute Myeloid Leukemia","volume":"21","author":"Angelini","year":"2015","journal-title":"Clin. Cancer Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1038\/s41408-022-00677-7","article-title":"Clinical outcomes in patients with relapsed\/refractory FLT3-mutated acute myeloid leukemia treated with gilteritinib who received prior midostaurin or sorafenib","volume":"12","author":"Perl","year":"2022","journal-title":"Blood Cancer J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1038\/s41375-022-01742-7","article-title":"Gilteritinib activity in refractory or relapsed FLT3-mutated acute myeloid leukemia patients previously treated by intensive chemotherapy and midostaurin: A study from the French AML Intergroup ALFA\/FILO","volume":"37","author":"Dumas","year":"2023","journal-title":"Leukemia"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1200\/JCO.23.02474","article-title":"Gilteritinib as Post-Transplant Maintenance for AML With Internal Tandem Duplication Mutation of FLT3","volume":"42","author":"Levis","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2958","DOI":"10.1182\/blood.2020006575","article-title":"Combinatorial treatment with menin and FLT3 inhibitors induces complete remission in AML models with activating FLT3 mutations","volume":"136","author":"Miao","year":"2020","journal-title":"Blood"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1182\/blood.2020005037","article-title":"Synergistic targeting of FLT3 mutations in AML via combined menin-MLL and FLT3 inhibition","volume":"136","author":"Dzama","year":"2020","journal-title":"Blood"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Goldberg, A. (2023, January 9\u201312). Komet-008: A phase 1 study to determine the safety and tolerability of ziftomenib combinations for the treatment of KMT2A-rearranged or NPM1-mutant relapsed\/refractory acute myeloid leukemia. Proceedings of the ASH Meeting, San Diego, CA, USA.","DOI":"10.1182\/blood-2023-190475"},{"key":"ref_76","unstructured":"Clinicaltrial.gov (2025, November 15). SNDX-5613 and Gilteritinib for the Treatment of Relapsed or Refractory FLT3-Mutated Acute Myeloid Leukemia and Concurrent MLL-Rearrangement or NPM1 Mutation, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06222580."},{"key":"ref_77","unstructured":"ClinicalTrial.gov (2025, November 15). Anti-FLT3 CAR-T Cell (TAA05 Cell Injection) in the Treatment of Relapsed\/Refractory Acute Myeloid Leukemia, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05445011."},{"key":"ref_78","unstructured":"ClinicalTrial.gov (2025, November 15). Evaluation of the Safety and Efficacy of Human CI-135 (FLT3) Targeted CAR-T Cells Injection for Subjects with Relapsed\/Refractory Acute Myeloid Leukemia, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06760260."},{"key":"ref_79","unstructured":"ClinicalTrial.gov (2025, November 15). Clinical Study of Anti-FLT3 CAR-T Cells for the Treatment of Relapsed\/Refractory AML, Available online: https:\/\/clinicaltrials.gov\/study\/NCT06786533."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/5\/770\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:11:00Z","timestamp":1772341860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/5\/770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":79,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["cancers18050770"],"URL":"https:\/\/doi.org\/10.3390\/cancers18050770","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}