Page 71 - EJMO-9-3

Eurasian Journal of Medicine

and Oncology

REVIEW ARTICLE
Dynamics of FLT3 mutations in acute myeloid

leukemia: A systematic review and meta-analysis
of shifts between diagnosis and relapsed/

refractory disease

Lais Teixeira , Camilla Correia , Alini Ponte , Diego Miranda ,
Felipe Feistauer , and Marco Aurélio Salvino*

Postgraduate Program in Medicine and Health, Professor Edgard Santos University Hospital,
Medical School, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil

Abstract

Acute myeloid leukemia (AML) is a hematologic malignancy with a generally poor
prognosis. Technological advances in molecular diagnosis have identified genetic
alterations driving AML pathogenesis, among which FMS-like tyrosine kinase 3 (FLT3)
mutations are significant. These mutations hold prognostic value and are increasingly
recognized as potential markers for disease monitoring. This systematic review
and meta-analysis aimed to assess the prevalence of changes in FLT3 mutational
status in adult patients with relapsed or refractory AML compared to their status
*Corresponding author:
Marco Aurélio Salvino at initial diagnosis. A relevant proportion of patients who were FLT3-wildtype at
(marcohemato@ufba.br) diagnosis were found to be FLT3-mutated on relapse, emphasizing the importance
Citation: Teixeira L, Correia C, of continuous mutation monitoring. Subgroup analyses were also performed, and
Ponte A, Miranda D, Feistauer F, mutation shift rates were reported across both FLT3 internal tandem duplication and
Salvino MA. Dynamics of FLT3 tyrosine kinase domain subtypes. These findings illustrate the genetic evolution of
mutations in acute myeloid
leukemia: A systematic review and leukemic clones and support the need for tailored therapeutic approaches based on
meta-analysis of shifts between the mutational profile at different disease stages. This study further highlights the
diagnosis and relapsed/refractory diagnostic and clinical utility of routine molecular reassessment and offers practical
disease. Eurasian J Med Oncol.
2025;9(3):63-74. recommendations for integrating FLT3 retesting into standard AML management.
doi: 10.36922/EJMO025150101
Received: April 10, 2025 Keywords: Acute myeloid leukemia; FMS-like tyrosine kinase 3 mutation; FMS-like
Revised: June 17, 2025 tyrosine kinase 3; Molecular biology
Accepted: July 16, 2025
Published online: August 7, 2025
1. Introduction
Copyright: © 2025 Author(s).
This is an Open Access article Acute myeloid leukemia (AML) is a hematologic malignancy that primarily affects
distributed under the terms of the
Creative Commons Attribution elderly individuals over the age of 60 years. Despite advances in supportive care
License, permitting distribution, therapies, AML remains associated with a poor prognosis, with an estimated 5-year
and reproduction in any medium, overall survival rate of approximately 40%. Studies conducted at the University Hospital
1
provided the original work is
properly cited. of the Federal University of Bahia reported a median overall survival of only 7–8 months
among adult patients. Given this clinical reality, a deeper understanding of the disease’s
2,3
Publisher’s Note: AccScience
Publishing remains neutral with pathophysiology is essential for identifying prognostic markers and therapeutic targets.
regard to jurisdictional claims in
published maps and institutional Advancements in molecular biology have significantly reshaped the AML landscape,
affiliations. particularly by enabling the identification of actionable mutations that may be targeted
Volume 9 Issue 3 (2025) 63 doi: 10.36922/EJMO025150101