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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 Teixeira1 ,  Camilla Correia1 ,  Alini Ponte1 ,  Diego Miranda1 ,  Felipe Feistauer1 ,  Marco Aurélio Salvino1*
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1 Postgraduate Program in Medicine and Health, Professor Edgard Santos University Hospital, Medical School, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
EJMO, 025150101 https://doi.org/10.36922/EJMO025150101
Received: 10 April 2025 | Revised: 17 June 2025 | Accepted: 16 July 2025 | Published online: 7 August 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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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 at initial diagnosis. A relevant proportion of patients who were FLT3-wildtype at diagnosis were found to be FLT3-mutated on relapse, emphasizing the importance of continuous mutation monitoring. Subgroup analyses were also performed, and mutation shift rates were reported across both FLT3 internal tandem duplication and tyrosine kinase domain subtypes. These findings illustrate the genetic evolution of leukemic clones and support the need for tailored therapeutic approaches based on the mutational profile at different disease stages. This study further highlights the diagnostic and clinical utility of routine molecular reassessment and offers practical recommendations for integrating FLT3 retesting into standard AML management.

Keywords
Acute myeloid leukemia
FMS-like tyrosine kinase 3 mutation
FMS-like tyrosine kinase 3
Molecular biology
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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