What is your general approach to post-allogeneic HSCT maintenance therapy for AML?

Topics: Hematologic Malignancies • Medical Oncology • Bone Marrow Transplant • Leukemia • Hematology

When is it warranted to utilize targeted therapies for known mutations (eg. midostaurin or an alternative TKI for FLT3 mutations, ivosidenib for IDH1 mutations, enasidenib for IDH2 mutations, etc)?

Is there benefit in patients without targetable mutations with the use of hypomethylating agents such as azacitidine?

Answer from: Medical Oncologist at Academic Institution

I use midostaurin starting 60-90 days after allogeneic transplant continued till 1 yr post transplant for patients with Flt-3 mutations. Some of my colleagues prefer sorafenib for post transplant maintenance in this setting. I have not yet started using IDH inhibitors post allogeneic transplant. HM...

Comments

Medical Oncologist at Uniformed Services University of the Health Sciences (USUHS)
Thank you for your response! In your experience...

Answer from: Medical Oncologist at Academic Institution

Relapse is the most important cause of treatment failure post allo HCT. However, to date no strategy has been conclusively shown to reduce or prevent recurrence. Having said that we approach every patient with greater than a 30% historical risk of recurrence within 2 years to consider relapse preve...

Related Questions