Page 79 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Molecular shift in FLT3 during AML course

decision-making, including the indication for allogeneic Author contributions
hematopoietic stem cell transplantation. Additionally,
FLT3 mutational profiling plays a pivotal role in selecting Conceptualization: Lais Teixeira, Camilla Correia, Marco
targeted therapies that are either currently approved or Salvino
under investigation. Formal analysis: Lais Teixeira
Methodology: Lais Teixeira
In this context, the observation that one in seven Writing–original draft: All authors
patients exhibited a change in FLT3 mutational status Writing–review & editing: Lais Teixeira, Marco Salvino
between diagnosis and relapse/refractoriness underscores
the clinical relevance of routine molecular reassessment Ethics approval and consent to participate
at disease progression. Such alterations may reflect the Not applicable.
expansion of pre-existing subclones at diagnosis or the
acquisition of de novo mutations associated with distinct Consent for publication
leukemic biology. The prognostic implications of these
molecular shifts remain to be fully elucidated and warrant Not applicable.
further investigation. Availability of data
There remains a pressing need to advance the sensitivity Data is available from the corresponding author upon
and breadth of diagnostic tools capable of detecting minor reasonable request.
subclonal populations at disease onset, as well as to better
characterize the mutational architecture and its dynamics References
over time. The incorporation of next-generation molecular 1. Döhner H, Estey EH, Amadori S, et al. Diagnosis and
technologies into healthcare systems is essential.
management of acute myeloid leukemia in adults:
Equally important is the continuous education Recommendations from an international expert
of healthcare professionals to ensure the appropriate panel, on behalf of the European leukemia net. Blood.
interpretation and integration of these tools into clinical 2010;115(3):453-474.
practice. Routine assessment of FLT3 mutations throughout doi: 10.1182/blood-2009-07-235358
the disease course is critical for optimizing the monitoring 2. Campos C, Orathes Ponte Silva AM, Feistauer F, Teixeira
and management of patients with AML. Da Silva L, Favano T, Salvino MA. 10-year real-world
We suggest further studies, including prospective data on acute myeloid leukemia: The paradigm of a public
cohort studies integrating PCR with NGS, along with more health center in Brazil. J Bone Marrow Transplant Cell Ther.
robust investigations incorporating cytogenetic analyses 2024;5(2):245.
at both diagnosis and relapse, co-occurring molecular doi: 10.46765/2675-374X.2024v5n2p245
alterations, and refined risk stratification models. 3. Feistauer F, Salvino M, Batista M, et al. Challenges to
Based on these findings, the prevalence of FLT3 achieving BMT in the treatment of AML in Brazil: Bahia
mutational profile changes is clinically relevant. We university hematology center experience. J Bone Marrow
therefore recommend performing PCR with fragment Transplant Cell Ther. 2023;4(3):214.
analysis to assess FLT3 mutations in all patients with AML, doi: 10.46765/2675-374X.2023v4n3p214
both at diagnosis and at relapse or refractory disease. 4. Hochhaus A, Baccarani M, Silver RT, et al. European
LeukemiaNet 2020 recommendations for treating chronic
Acknowledgments myeloid leukemia. Leukemia. 2020;34(4):966-984.
The authors would like to thank the Hematology Division doi: 10.1038/s41375-020-0776-2
of UFBA Clinics Hospital and the UFBA Postgraduate 5. Nakao M, Yokota S, Iwai T, et al. Internal tandem duplication
Program in Medicine and Health for their invaluable input of the flt3 gene found in acute myeloid leukemia. Leukemia.
and support throughout the research process. 1996;10:1911-1918.

Funding 6. Kiyoi H, Naoe T, Nakano Y, et al. Prognostic implication of
FLT3 and N-RAS gene mutations in acute myeloid leukemia.
None. Blood. 1999;93:3074-3080.

Conflict of interest 7. Reindl C, Spiekermann K. From kinases to cancer:
Leakiness, loss of autoinhibition and leukemia. Cell Cycle.
The authors declare they have no competing interests. 2006;5(6):599-602.

Volume 9 Issue 3 (2025) 71 doi: 10.36922/EJMO025150101