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A 35‐year‐old man is diagnosed with acute myeloid leukaemia with normal karyotype. FLT3 internal tandem duplication is present, while nucleophosmin is wild type and a 22‐gene molecular panel shows no further mutations. Which ONE of the following is the most appropriate initial therapy for this patient? (P) A Combination chemotherapy and midostaurin B Immediate allogeneic stem cell transplantation with myeloablative conditioning C Gemtuzumab ozogamicin, hydroxycarbamide and decitabine D Combination chemotherapy and dasatinib

Question

A 35‐year‐old man is diagnosed with acute myeloid leukaemia with normal karyotype. FLT3 internal tandem duplication is present, while nucleophosmin is wild type and a 22‐gene molecular panel shows no further mutations. Which ONE of the following is the most appropriate initial therapy for this patient? (P) A Combination chemotherapy and midostaurin B Immediate allogeneic stem cell transplantation with myeloablative conditioning C Gemtuzumab ozogamicin, hydroxycarbamide and decitabine D Combination chemotherapy and dasatinib

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Solution

The most appropriate initial therapy for this patient would be (P) A Combination chemotherapy and midostaurin. This is because the patient has acute myeloid leukaemia (AML) with a FLT3 internal tandem duplication mutation. Midostaurin is a multi-targeted kinase inhibitor that has been shown to improve survival in patients with AML and a FLT3 mutation when given in combination with standard chemotherapy.

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