ArticleBlood research2026
Real-world experience with gilteritinib maintenance following allogeneic transplantation in relapsed/refractory AML patients harboring FLT3 mutations.
Article in Blood research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGilteritinib is an established FLT3 inhibitor used to treat patients with relapsed or refractory (R/R) acute myeloid leukemia (AML) harboring FLT3 mutations. Prior studies have predominantly evaluated gilteritinib as a posttransplant maintenance therapy in patients who undergo allogeneic hematopoietic stem cell transplantation (allo-HSCT) in complete remission. Nonetheless, evidence remains limited for patients who receive gilteritinib as salvage therapy in a relapsed or refractory setting, proceed to allo-HSCT, and subsequently continue gilteritinib maintenance. This real-world study aimed to address this knowledge gap in an Asian cohort. METHOD AND
resultPatients with FLT3-mutated R/R AML received gilteritinib before transplantation, and those achieving engraftment without grade ≥ 2 acute graft-versus-host disease were offered posttransplant maintenance between days 30 and 90. The cohort (median age, 48 years; 92.0% FLT3-ITD) achieved a complete response (CR) rate of 76.2%. At a median follow-up of 46.2 months, gilteritinib maintenance therapy was associated with longer relapse-free and overall survival and a significantly lower 1-year cumulative incidence of relapse. Exploratory measurable residual disease (MRD) subgroup analyses suggested a numerically greater survival difference in patients without flow cytometry-detectable MRD before or after transplantation; however, the findings are limited by the small sample size and lack of FLT3-targeted next-generation sequencing-based MRD assessment.
conclusionGilteritinib was generally well-tolerated, with no observed increase in cytomegalovirus (CMV)-related or graft-versus-host complications. This study provides real-world evidence in a clinically relevant scenario and supports the use of gilteritinib maintenance in patients with FLT3-mutated AML who undergo transplantation during R/R disease.
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