Treatment with midostaurin and other FLT3 targeting inhibitors is associated with an increased risk of cardiovascular adverse events in patients who underwent allogeneic hematopoietic stem cell transplantation with FLT3-mutated AML

Ann Hematol. 2023 Oct;102(10):2903-2908. doi: 10.1007/s00277-023-05396-y. Epub 2023 Aug 8.

Abstract

The addition of midostaurin to standard chemotherapy has improved survival in patients with FLT3-mutated AML. However, the impact of midostaurin and other FLT3 inhibitors (FLT3i) on cardiovascular adverse events (CAEs) has not been studied in patients who underwent allogeneic hematopoietic stem cell transplantation in a real-world setting. We reviewed 132 patients with AML who were treated with intensive induction therapy and consecutive allogeneic stem cell transplantation at our institution (42 FLT3-mutated AML and 90 with FLT3 wildtype). We identified treatment with midostaurin and/or FLT3i as an independent risk factor for CAEs not resulting in higher non-relapse mortality (NRM) or impaired overall survival (OS). Hence, close monitoring for CAEs is warranted for these patients.

Keywords: Acute myeloid leukemia; Allogeneic stem cell transplantation; Cardiac toxicities; Targeted FLT3 inhibitor therapy.

Publication types

  • Review

MeSH terms

  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Leukemia, Myeloid, Acute* / drug therapy
  • Leukemia, Myeloid, Acute* / therapy
  • Mutation
  • Protein Kinase Inhibitors / adverse effects
  • Staurosporine / adverse effects
  • fms-Like Tyrosine Kinase 3 / genetics

Substances

  • midostaurin
  • Staurosporine
  • Protein Kinase Inhibitors
  • fms-Like Tyrosine Kinase 3
  • FLT3 protein, human