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  For patients with acute myeloid leukemia (AML),
consider mutation testing at relapse
In AML, mutation status may change1
In a retrospective analysis of patients with FLT3-ITD-negative AML, 10% of patients who relapsed from standard treatment had acquired a FLT3-ITD mutation1
Other FLT3 mutations may emerge during treatment2
FLT3 mutations adversely impact outcomes in AML3
FLT3-ITD mutations are associated with negative prognosis in patients with AML compared to patients with wild-type FLT3, including higher risk of relapse and increased risk of death3
  Confirming FLT3 mutation status in patients with relapsed AML
may help inform your treatment strategy.4
  FLT3, FMS-like tyrosine kinase 3; ITD, internal tandem duplication  
  References: 1. Nazha A, Cortes J, Faderl S, et al. Activating internal tandem duplication mutations of the fms-like tyrosine kinase-3 (FLT3-ITD) at complete response and relapse in patients with acute myeloid leukemia. Haematologica 2012;97(8):1242-5. 2. Alvarado Y, Kantarjian HM, Luthra R, et al. Treatment with FLT3 inhibitor in patients with FLT3-mutated acute myeloid leukemia is associated with development of secondary FLT3–tyrosine kinase domain mutations. Cancer 2014;120(14):2142-9. 3. Whitman SP, Maharry K, Radmacher MD, et al. FLT3 internal tandem duplication associates with adverse outcome and gene- and microRNA-expression signatures in patients 60 years of age or older with primary cytogenetically normal acute myeloid leukemia: a Cancer and Leukemia Group B study. Blood 2010;116(18):3622-6. 4. Luskin MR, Carroll M, Lieberman D, et al. Clinical utility of next-generation sequencing for oncogenic mutations in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2016;22(11):1961-7.  
  © 2018 Astellas Pharma US, Inc. All rights reserved. 077-0495-PM 12/18
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