Abstract
Constitutively activated FLT3 as a consequence of mutation has rapidly become a hallmark of acute myeloid leukemia (AML). With the prompt development of several small molecule FLT3 inhibitors and the current ongoing clinical trials using such compounds, FLT3 inhibition seems well on its way to soon becoming incorporated routinely into AML treatment protocols. In acute lymphoblastic leukemia (ALL), constitutively activated FLT3 appears to be an attractive therapeutic target particularly for patients carrying unfavorable translocations of the MLL gene. Here, we review the accomplishments regarding FLT3 inhibition in AML, and in parallel describe the trailing exploration of the potential of FLT3 inhibitors as therapeutic agents in MLL rearranged ALL.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
O. Rosnet, and D. Birnbaum, Hematopoietic receptors of class III receptor-type tyrosine kinases. Crit Rev Oncog. 1993; 4:595–613.
O. Rosnet, H.J. Buhring, S. Marchetto, I. Rappold, C. Lavagna, D. Sainty, C. Arnoulet, C. Chabannon, L. Kanz, C. Hannum, and D. Birnbaum, Human FLT3/FLK2 receptor tyrosine kinase is expressed at the surface of normal and malignant hematopoietic cells. Leukemia. 1996; 10:238–48.
K. Mackarehtschian, J.D. Hardin, K.A. Moore, S. Boast, S.P. Goff, and I.R. Lemischka, Targeted disruption of the flk2/flt3 gene leads to deficiencies in primitive hematopoietic progenitors. Immunity. 1995; 3:147–61.
J. Griffith, J. Black, C. Faerman, L. Swenson, M. Wynn, F. Lu, J. Lippke, and K. Saxena, The structural basis for autoinhibition of FLT3 by the juxtamembrane domain. Mol Cell. 2004; 13:169–78.
C. Hannum, J. Culpepper, D. Campbell, T. McClanahan, S. Zurawski, J.F. Bazan, R. Kastelein, S. Hudak, J. Wagner, J. Mattson, and et al., Ligand for FLT3/FLK2 receptor tyrosine kinase regulates growth of haematopoietic stem cells and is encoded by variant RNAs. Nature. 1994; 168:643–8.
S.N. Savvides, T. Boone, and P. Andrew Karplus, Flt3 ligand structure and unexpected commonalities of helical bundles and cystine knots. Nat Struct Biol. 2000; 7:486–91.
D.L. Stirewalt, and J.P. Radich, The role of FLT3 in haematopoietic malignancies. Nat Rev Cancer. 2003; 3:650–65.
Y. Kikushige, G. Yoshimoto, T. Miyamoto, T. Iino, Y. Mori, H. Iwasaki, H. Niiro, K. Takenaka, K. Nagafuji, M. Harada, F. Ishikawa, and K. Akashi, Human Flt3 is expressed at the hematopoietic stem cell and the granulocyte/macrophage progenitor stages to maintain cell survival. J Immunol. 2008; 180:7358–67.
K.C. Weisel, S. Yildirim, E. Schweikle, L. Kanz, and R. Mohle, Regulation of FLT3 and its ligand in normal hematopoietic progenitor cells. Ann Hematol. 2009; 88:203–11.
M. Nakao, S. Yokota, T. Iwai, H. Kaneko, S. Horiike, K. Kashima, Y. Sonoda, T. Fujimoto, and S. Misawa, Internal tandem duplication of the flt3 gene found in acute myeloid leukemia. Leukemia. 1996; 10:1911–8.
H. Kiyoi, R. Ohno, R. Ueda, H. Saito, and T. Naoe, Mechanism of constitutive activation of FLT3 with internal tandem duplication in the juxtamembrane domain. Oncogene. 2002; 21:2555–63.
T. Furitsu, T. Tsujimura, T. Tono, H. Ikeda, H. Kitayama, U. Koshimizu, H. Sugahara, J.H. Butterfield, L.K. Ashman, Y. Kanayama, and et al., Identification of mutations in the coding sequence of the proto-oncogene c-kit in a human mast cell leukemia cell line causing ligand-independent activation of c-kit product. J Clin Invest. 1993; 92:1736–44.
Y. Yamamoto, H. Kiyoi, Y. Nakano, R. Suzuki, Y. Kodera, S. Miyawaki, N. Asou, K. Kuriyama, F. Yagasaki, C. Shimazaki, H. Akiyama, K. Saito, M. Nishimura, T. Motoji, K. Shinagawa, A. Takeshita, H. Saito, R. Ueda, R. Ohno, and T. Naoe, Activating mutation of D835 within the activation loop of FLT3 in human hematologic malignancies. Blood. 2001; 97:2434–9.
M. Bianchini, E. Ottaviani, T. Grafone, B. Giannini, S. Soverini, C. Terragna, M. Amabile, P.P. Piccaluga, M. Malagola, M. Rondoni, C. Bosi, M. Baccarani, and G. Martinelli, Rapid detection of Flt3 mutations in acute myeloid leukemia patients by denaturing HPLC. Clin Chem. 2003; 49:1642–50.
R.W. Stam, M.L. den Boer, P. Schneider, M. Meier, H.B. Beverloo, and R. Pieters, D-HPLC analysis of the entire FLT3 gene in MLL rearranged and hyperdiploid acute lymphoblastic leukemia. Haematologica. 2007; 92:1565–8.
S. Frohling, C. Scholl, R.L. Levine, M. Loriaux, T.J. Boggon, O.A. Bernard, R. Berger, H. Dohner, K. Dohner, B.L. Ebert, S. Teckie, T.R. Golub, J. Jiang, M.M. Schittenhelm, B.H. Lee, J.D. Griffin, R.M. Stone, M.C. Heinrich, M.W. Deininger, B.J. Druker, and D.G. Gilliland, Identification of driver and passenger mutations of FLT3 by high-throughput DNA sequence analysis and functional assessment of candidate alleles. Cancer Cell. 2007; 12:501–13.
M.M. Schittenhelm, K.W. Yee, J.W. Tyner, L. McGreevey, A.D. Haley, A. Town, D.J. Griffith, T. Bainbridge, R.M. Braziel, A.M. O’Farrell, J.M. Cherrington, and M.C. Heinrich, FLT3 K663Q is a novel AML-associated oncogenic kinase: Determination of biochemical properties and sensitivity to Sunitinib (SU11248). Leukemia. 2006; 20:2008–14.
C. Choudhary, C. Muller-Tidow, W.E. Berdel, and H. Serve, Signal transduction of oncogenic Flt3. Int J Hematol. 2005; 82:93–9.
D. Small, FLT3 mutations: biology and treatment. Hematology. Am Soc Hematol Educ Program. 2006;178–84.
R. Zheng, A.D. Friedman, M. Levis, L. Li, E.G. Weir, and D. Small, Internal tandem duplication mutation of FLT3 blocks myeloid differentiation through suppression of C/EBPalpha expression. Blood. 2004; 103:1883–90.
H.S. Radomska, D.S. Basseres, R. Zheng, P. Zhang, T. Dayaram, Y. Yamamoto, D.W. Sternberg, N. Lokker, N.A. Giese, S.K. Bohlander, S. Schnittger, M.H. Delmotte, R.J. Davis, D. Small, W. Hiddemann, D.G. Gilliland, and D.G. Tenen, Block of C/EBP alpha function by phosphorylation in acute myeloid leukemia with FLT3 activating mutations. J Exp Med. 2006; 203:371–81.
A. Sallmyr, J. Fan, K. Datta, K.T. Kim, D. Grosu, P. Shapiro, D. Small, and F. Rassool, Internal tandem duplication of FLT3 (FLT3/ITD) induces increased ROS production, DNA damage, and misrepair: implications for poor prognosis in AML. Blood. 2008; 111:3173–82.
M. Mizuki, R. Fenski, H. Halfter, I. Matsumura, R. Schmidt, C. Muller, W. Gruning, K. Kratz-Albers, S. Serve, C. Steur, T. Buchner, J. Kienast, Y. Kanakura, W.E. Berdel, and H. Serve, Flt3 mutations from patients with acute myeloid leukemia induce transformation of 32D cells mediated by the Ras and STAT5 pathways. Blood. 2000; 96:3907–14.
K. Spiekermann, K. Bagrintseva, R. Schwab, K. Schmieja, and W. Hiddemann, Overexpression and constitutive activation of FLT3 induces STAT5 activation in primary acute myeloid leukemia blast cells. Clin Cancer Res. 2003; 9:2140–50.
K.F. Tse, G. Mukherjee, and D. Small, Constitutive activation of FLT3 stimulates multiple intracellular signal transducers and results in transformation. Leukemia. 2000; 14:1766–76.
P.D. Kottaridis, R.E. Gale, S.E. Langabeer, M.E. Frew, D.T. Bowen, and D.C. Linch, Studies of FLT3 mutations in paired presentation and relapse samples from patients with acute myeloid leukemia: implications for the role of FLT3 mutations in leukemogenesis, minimal residual disease detection, and possible therapy with FLT3 inhibitors. Blood. 2002; 100:2393–8.
L.Y. Shih, C.F. Huang, J.H. Wu, P.N. Wang, T.L. Lin, P. Dunn, M.C. Chou, M.C. Kuo, and C.C. Tang, Heterogeneous patterns of FLT3 Asp(835) mutations in relapsed de novo acute myeloid leukemia: a comparative analysis of 120 paired diagnostic and relapse bone marrow samples. Clin Cancer Res. 2004; 10:1326–32.
D.G. Gilliland, and J.D. Griffin, The roles of FLT3 in hematopoiesis and leukemia. Blood. 2002; 100:1532–42.
S. Meshinchi, T.A. Alonzo, D.L. Stirewalt, M. Zwaan, M. Zimmerman, D. Reinhardt, G.J. Kaspers, N.A. Heerema, R. Gerbing, B.J. Lange, and J.P. Radich, Clinical implications of FLT3 mutations in pediatric AML. Blood. 2006; 108:3654–61.
F.M. Abu-Duhier, A.C. Goodeve, G.A. Wilson, R.S. Care, I.R. Peake, and J.T. Reilly, Identification of novel FLT-3 Asp835 mutations in adult acute myeloid leukemia. Br J Haematol. 2001; 113:983–8.
S. Meshinchi, D.L. Stirewalt, T.A. Alonzo, Q. Zhang, D.A. Sweetser, W.G. Woods, I.D. Bernstein, R.J. Arceci, and J.P. Radich, Activating mutations of RTK/ras signal transduction pathway in pediatric acute myeloid leukemia. Blood. 2003; 102:1474–9.
C. Thiede, C. Steudel, B. Mohr, M. Schaich, U. Schakel, U. Platzbecker, M. Wermke, M. Bornhauser, M. Ritter, A. Neubauer, G. Ehninger, and T. Illmer, Analysis of FLT3-activating mutations in 979 patients with acute myelogenous leukemia: association with FAB subtypes and identification of subgroups with poor prognosis. Blood. 2002; 99:4326–35.
M. Braoudaki, M. Karpusas, K. Katsibardi, C. Papathanassiou, K. Karamolegou, and F. Tzortzatou-Stathopoulou, Frequency of FLT3 mutations in childhood acute lymphoblastic leukemia. Med Oncol. 2008; 26:460–2.
T. Taketani, T. Taki, K. Sugita, Y. Furuichi, E. Ishii, R. Hanada, M. Tsuchida, K. Ida, and Y. Hayashi, FLT3 mutations in the activation loop of tyrosine kinase domain are frequently found in infant ALL with MLL rearrangements and pediatric ALL with hyperdiploidy. Blood. 2004; 103:1085–8.
A. Andersson, K. Paulsson, H. Lilljebjorn, C. Lassen, B. Strombeck, J. Heldrup, M. Behrendtz, B. Johansson, and T. Fioretos, FLT3 mutations in a 10 year consecutive series of 177 childhood acute leukemias and their impact on global gene expression patterns. Genes Chromosomes Cancer. 2008; 47:64–70.
K. Paulsson, A. Horvat, B. Strombeck, F. Nilsson, J. Heldrup, M. Behrendtz, E. Forestier, A. Andersson, T. Fioretos, and B. Johansson, Mutations of FLT3, NRAS, KRAS, and PTPN11 are frequent and possibly mutually exclusive in high hyperdiploid childhood acute lymphoblastic leukemia. Genes Chromosomes Cancer. 2008; 47:26–33.
S.A. Armstrong, M.E. Mabon, L.B. Silverman, A. Li, J.G. Gribben, E.A. Fox, S.E. Sallan, and S.J. Korsmeyer, FLT3 mutations in childhood acute lymphoblastic leukemia. Blood. 2004; 103:3544–6.
S.A. Armstrong, A.L. Kung, M.E. Mabon, L.B. Silverman, R.W. Stam, M.L. Den Boer, R. Pieters, J.H. Kersey, S.E. Sallan, J.A. Fletcher, T.R. Golub, J.D. Griffin, and S.J. Korsmeyer, Inhibition of FLT3 in MLL. Validation of a therapeutic target identified by gene expression based classification. Cancer Cell. 2003; 3:173–83.
R.W. Stam, M.L. den Boer, P. Schneider, P. Nollau, M. Horstmann, H.B. Beverloo, E. van der Voort, M.G. Valsecchi, P. de Lorenzo, S.E. Sallan, S.A. Armstrong, and R. Pieters, Targeting FLT3 in primary MLL-gene-rearranged infant acute lymphoblastic leukemia. Blood. 2005; 106:2484–90.
S.A. Armstrong, J.E. Staunton, L.B. Silverman, R. Pieters, M.L. den Boer, M.D. Minden, S.E. Sallan, E.S. Lander, T.R. Golub, and S.J. Korsmeyer, MLL translocations specify a distinct gene expression profile that distinguishes a unique leukemia. Nat Genet. 2002; 30:41–7.
P. Brown, M. Levis, S. Shurtleff, D. Campana, J. Downing, and D. Small, FLT3 inhibition selectively kills childhood acute lymphoblastic leukemia cells with high levels of FLT3 expression. Blood. 2005; 105:812–20.
R.W. Stam, P. Schneider, P. de Lorenzo, M.G. Valsecchi, M.L. den Boer, and R. Pieters, Prognostic significance of high-level FLT3 expression in MLL-rearranged infant acute lymphoblastic leukemia. Blood. 2007; 110:2774–5.
K. Ozeki, H. Kiyoi, Y. Hirose, M. Iwai, M. Ninomiya, Y. Kodera, S. Miyawaki, K. Kuriyama, C. Shimazaki, H. Akiyama, M. Nishimura, T. Motoji, K. Shinagawa, A. Takeshita, R. Ueda, R. Ohno, N. Emi, and T. Naoe, Biologic and clinical significance of the FLT3 transcript level in acute myeloid leukemia. Blood. 2004; 103:1901–8.
E. Weisberg, C. Boulton, L.M. Kelly, P. Manley, D. Fabbro, T. Meyer, D.G. Gilliland, and J.D. Griffin, Inhibition of mutant FLT3 receptors in leukemia cells by the small molecule tyrosine kinase inhibitor PKC412. Cancer Cell. 2002; 1:433–43.
M. Levis, J. Allebach, K.F. Tse, R. Zheng, B.R. Baldwin, B.D. Smith, S. Jones-Bolin, B. Ruggeri, C. Dionne, and D. Small, A FLT3-targeted tyrosine kinase inhibitor is cytotoxic to leukemia cells in vitro and in vivo. Blood. 2002; 99:3885–91.
A.M. O’Farrell, T.J. Abrams, H.A. Yuen, T.J. Ngai, S.G. Louie, K.W. Yee, L.M. Wong, W. Hong, L.B. Lee, A. Town, B.D. Smolich, W.C. Manning, L.J. Murray, M.C. Heinrich, and J.M. Cherrington, SU11248 is a novel FLT3 tyrosine kinase inhibitor with potent activity in vitro and in vivo. Blood. 2003; 101:3597–605.
K. Spiekermann, R.J. Dirschinger, R. Schwab, K. Bagrintseva, F. Faber, C. Buske, S. Schnittger, L.M. Kelly, D.G. Gilliland, and W. Hiddemann, The protein tyrosine kinase inhibitor SU5614 inhibits FLT3 and induces growth arrest and apoptosis in AML-derived cell lines expressing a constitutively activated FLT3. Blood. 2003; 101:1494–504.
F.J. Giles, A.T. Stopeck, L.R. Silverman, J.E. Lancet, M.A. Cooper, A.L. Hannah, J.M. Cherrington, A.M. O’Farrell, H.A. Yuen, S.G. Louie, W. Hong, J.E. Cortes, S. Verstovsek, M. Albitar, S.M. O’Brien, H.M. Kantarjian, and J.E. Karp, SU5416, a small molecule tyrosine kinase receptor inhibitor, has biologic activity in patients with refractory acute myeloid leukemia or myelodysplastic syndromes. Blood. 2003; 102:795–801.
L.Q. Chow, and S.G. Eckhardt, Sunitinib: from rational design to clinical efficacy. J Clin Oncol. 2007; 25:884–96.
D. Fabbro, S. Ruetz, S. Bodis, M. Pruschy, K. Csermak, A. Man, P. Campochiaro, J. Wood, T. O’Reilly, and T. Meyer, PKC412--a protein kinase inhibitor with a broad therapeutic potential. Anticancer Drug Des. 2000; 15:17–28.
D.J. George, C.A. Dionne, J. Jani, T. Angeles, C. Murakata, J. Lamb, and J.T. Isaacs, Sustained in vivo regression of Dunning H rat prostate cancers treated with combinations of androgen ablation and Trk tyrosine kinase inhibitors, CEP-751 (KT-6587) or CEP-701 (KT-5555). Cancer Res. 1999; 59:2395–401.
S. Knapper, K.I. Mills, A.F. Gilkes, S.J. Austin, V. Walsh, and A.K. Burnett, The effects of lestaurtinib (CEP701) and PKC412 on primary AML blasts: the induction of cytotoxicity varies with dependence on FLT3 signaling in both FLT3-mutated and wild-type cases. Blood. 2006; 108:3494–503.
K.W. Yee, M. Schittenhelm, A.M. O’Farrell, A.R. Town, L. McGreevey, T. Bainbridge, J.M. Cherrington, and M.C. Heinrich, Synergistic effect of SU11248 with cytarabine or daunorubicin on FLT3 ITD-positive leukemic cells. Blood. 2004; 104:4202–9.
P. Brown, S. Meshinchi, M. Levis, T.A. Alonzo, R. Gerbing, B. Lange, R. Arceci, and D. Small, Pediatric AML primary samples with FLT3/ITD mutations are preferentially killed by FLT3 inhibition. Blood. 2004; 104:1841–9.
A.J. Mead, R.E. Gale, P.D. Kottaridis, S. Matsuda, A. Khwaja, and D.C. Linch, Acute myeloid leukemia blast cells with a tyrosine kinase domain mutation of FLT3 are less sensitive to lestaurtinib than those with a FLT3 internal tandem duplication. Br J Haematol. 2008; 141:454–60.
R. Grundler, C. Thiede, C. Miething, C. Steudel, C. Peschel, and J. Duyster, Sensitivity toward tyrosine kinase inhibitors varies between different activating mutations of the FLT3 receptor. Blood. 2003; 102:646–51.
J.J. Clark, J. Cools, D.P. Curley, J.C. Yu, N.A. Lokker, N.A. Giese, and D.G. Gilliland, Variable sensitivity of FLT3 activation loop mutations to the small molecule tyrosine kinase inhibitor MLN518. Blood. 2004; 104:2867–72.
E.V. Barry, J.J. Clark, J. Cools, J. Roesel, and D.G. Gilliland, Uniform sensitivity of FLT3 activation loop mutants to the tyrosine kinase inhibitor midostaurin. Blood. 2007; 110:4476-9.
B.D. Smith, M. Levis, M. Beran, F. Giles, H. Kantarjian, K. Berg, K.M. Murphy, T. Dauses, J. Allebach, and D. Small, Single-agent CEP-701, a novel FLT3 inhibitor, shows biologic and clinical activity in patients with relapsed or refractory acute myeloid leukemia. Blood. 2004; 103:3669–76.
S. Knapper, A.K. Burnett, T. Littlewood, W.J. Kell, S. Agrawal, R. Chopra, R. Clark, M.J. Levis, and D. Small, A phase 2 trial of the FLT3 inhibitor lestaurtinib (CEP701) as first-line treatment for older patients with acute myeloid leukemia not considered fit for intensive chemotherapy. Blood. 2006; 108:3262–70.
R.M. Stone, D.J. DeAngelo, V. Klimek, I. Galinsky, E. Estey, S.D. Nimer, W. Grandin, D. Lebwohl, Y. Wang, P. Cohen, E.A. Fox, D. Neuberg, J. Clark, D.G. Gilliland, and J.D. Griffin, Patients with acute myeloid leukemia and an activating mutation in FLT3 respond to a small-molecule FLT3 tyrosine kinase inhibitor, PKC412. Blood. 2005; 105:54–60.
D.J. DeAngelo, R.M. Stone, M.L. Heaney, S.D. Nimer, R.L. Paquette, R.B. Klisovic, M.A. Caligiuri, M.R. Cooper, J.M. Lecerf, M.D. Karol, S. Sheng, N. Holford, P.T. Curtin, B.J. Druker, and M.C. Heinrich, Phase 1 clinical results with tandutinib (MLN518), a novel FLT3 antagonist, in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome: safety, pharmacokinetics, and pharmacodynamics. Blood. 2006; 108:3674–81.
M. Levis, R. Pham, B.D. Smith, and D. Small, In vitro studies of a FLT3 inhibitor combined with chemotherapy: sequence of administration is important to achieve synergistic cytotoxic effects. Blood. 2004; 104:1145–50.
L. Mollgard, S. Deneberg, H. Nahi, S. Bengtzen, K. Jonsson-Videsater, T. Fioretos, A. Andersson, C. Paul, and S. Lehmann, The FLT3 inhibitor PKC412 in combination with cytostatic drugs in vitro in acute myeloid leukemia. Cancer Chemother Pharmacol. 2008; 62:439–48.
S. Kasper, F. Breitenbuecher, Y. Hoehn, F. Heidel, D.B. Lipka, B. Markova, C. Huber, T. Kindler, and T. Fischer, The kinase inhibitor LS104 induces apoptosis, enhances cytotoxic effects of chemotherapeutic drugs and is targeting the receptor tyrosine kinase FLT3 in acute myeloid leukemia. Leuk Res. 2008; 32:1698–708.
M. Levis, P. Brown, B.D. Smith, A. Stine, R. Pham, R. Stone, D. Deangelo, I. Galinsky, F. Giles, E. Estey, H. Kantarjian, P. Cohen, Y. Wang, J. Roesel, J.E. Karp, and D. Small, Plasma inhibitory activity (PIA): a pharmacodynamic assay reveals insights into the basis for cytotoxic response to FLT3 inhibitors. Blood. 2006; 108:3477–83.
G.W. Krystal, Mechanisms of resistance to imatinib (STI571) and prospects for combination with conventional chemotherapeutic agents. Drug Resist Updat. 2001; 4:16–21.
M.W. Drummond, and T.L. Holyoake, Tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia: so far so good? Blood Rev. 2001; 15:85–95.
S.H. Chu, and D. Small, Mechanisms of resistance to FLT3 inhibitors. Drug Resist Updat. 2009; 12:8–16.
F. Heidel, F.K. Solem, F. Breitenbuecher, D.B. Lipka, S. Kasper, M.H. Thiede, C. Brandts, H. Serve, J. Roesel, F. Giles, E. Feldman, G. Ehninger, G.J. Schiller, S. Nimer, R.M. Stone, Y. Wang, T. Kindler, P.S. Cohen, C. Huber, and T. Fischer, Clinical resistance to the kinase inhibitor PKC412 in acute myeloid leukemia by mutation of Asn-676 in the FLT3 tyrosine kinase domain. Blood. 2006; 107:293–300.
O. Piloto, M. Wright, P. Brown, K.T. Kim, M. Levis, and D. Small, Prolonged exposure to FLT3 inhibitors leads to resistance via activation of parallel signaling pathways. Blood. 2007; 109:1643–52.
T.M. Kohl, C. Hellinger, F. Ahmed, C. Buske, W. Hiddemann, S.K. Bohlander, and K. Spiekermann, BH3 mimetic ABT-737 neutralizes resistance to FLT3 inhibitor treatment mediated by FLT3-independent expression of BCL2 in primary AML blasts. Leukemia. 2007; 21:1763–72.
F. Breitenbuecher, B. Markova, S. Kasper, B. Carius, T. Stauder, F.D. Bohmer, K. Masson, L. Ronnstrand, C. Huber, T. Kindler, and T. Fischer, A novel molecular mechanism of primary resistance to FLT3-kinase inhibitors in acute myeloid leukemia. Blood. 2009; 113:4063-73.
U. Mony, M. Jawad, C. Seedhouse, N. Russell, and M. Pallis, Resistance to FLT3 inhibition in an in vitro model of primary AML cells with a stem cell phenotype in a defined microenvironment. Leukemia. 2008; 22:1395–401.
N.P. Shah, C. Tran, F.Y. Lee, P. Chen, D. Norris, and C.L. Sawyers, Overriding imatinib resistance with a novel ABL kinase inhibitor. Science. 2004; 305:399–401.
F. Heidel, D.B. Lipka, F.K. Mirea, S. Mahboobi, R. Grundler, R.K. Kancha, J. Duyster, M. Naumann, C. Huber, F.D. Bohmer, and T. Fischer, Bis(1H-indol-2-yl)methanones are effective inhibitors of FLT3-ITD tyrosine kinase and partially overcome resistance to PKC412A in vitro. Br J Haematol. 2009; 144:865–74.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC 2011
About this chapter
Cite this chapter
Stam, R.W., Pieters, R. (2011). FLT3 Inhibitors as Therapeutic Agents in MLL Rearranged Acute Lymphoblastic Leukemia. In: Saha, V., Kearns, P. (eds) New Agents for the Treatment of Acute Lymphoblastic Leukemia. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-8459-3_10
Download citation
DOI: https://doi.org/10.1007/978-1-4419-8459-3_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-8458-6
Online ISBN: 978-1-4419-8459-3
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)