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Living with cancer· Appointment prep

Appointment sheet: FLT3-mutated acute myeloid leukaemia

One page to bring and write on: your details, the questions for FLT3-mutated acute myeloid leukaemia plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

FLT3-mutated acute myeloid leukaemia

Prepared with OnCo (onco.cc/prep/aml-flt3/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

18 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example FLT3-ITD and allelic ratio, FLT3-TKD, NPM1 co-mutation, ELN 2022 risk group, FLT3-ITD MRD by NGS before and after transplant), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Newly diagnosed, fit for intensive chemotherapy
  1. 5.For my situation (newly diagnosed, fit for intensive chemotherapy), which of the standard options do you recommend and why?
  2. 6.Am I a candidate for Midostaurin, Quizartinib, Cytarabine + anthracycline ('7+3'), and what side effects should I expect?
  3. 7.How do the results of RATIFY (CALGB 10603) and QuANTUM-First apply to someone like me?
Newly diagnosed, unfit for intensive chemotherapy
  1. 8.For my situation (newly diagnosed, unfit for intensive chemotherapy), which of the standard options do you recommend and why?
  2. 9.Am I a candidate for Venetoclax, Azacitidine, Gilteritinib, and what side effects should I expect?
  3. 10.How do the results of VIALE-A apply to someone like me?
Relapsed or refractory
  1. 11.For my situation (relapsed or refractory), which of the standard options do you recommend and why?
  2. 12.Am I a candidate for Gilteritinib, Quizartinib, and what side effects should I expect?
  3. 13.How do the results of ADMIRAL apply to someone like me?
Any stage
  1. 14.Are there clinical trials I could join, for example of Gilteritinib, Quizartinib, Venetoclax, myeloMATCH?
  2. 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 17.I read that “Which FLT3 inhibitor to pair with intensive chemotherapy, and whether one inhibitor suits both ITD and TKD disease”. How does that affect my plan?
  5. 18.I read that “Whether post-transplant maintenance should be given to everyone or only to patients with detectable FLT3-ITD”. How does that affect my plan?

The words I may hear

  • 7+3 induction chemotherapy: The classic first treatment for acute myeloid leukaemia, unchanged since 1973: seven days of continuous cytarabine plus three days of an anthracycline, given in hospital.
  • FLT3-ITD allelic ratio: How much of the FLT3 gene in the leukaemia carries the internal duplication, measured as the ratio of mutant to normal copies.
  • ELN 2022 risk classification: The three-tier system (favourable, intermediate, adverse) that decides how aggressively an adult with AML is treated and whether a transplant is recommended.

Tests and results to bring

Newly diagnosed, fit for intensive chemotherapy: 7+3 induction with midostaurin (RATIFY) or, for FLT3-ITD, quizartinib (QuANTUM-First), then consolidation and maintenance with the same inhibitor; allogeneic transplant in first remission for most FLT3-ITD patients.

Newly diagnosed, unfit for intensive chemotherapy: Venetoclax plus azacitidine, with a FLT3 inhibitor added in trials or where labelled; gilteritinib with azacitidine is an option.

Biomarker results to ask for: FLT3-ITD and allelic ratio, FLT3-TKD (D835, I836), NPM1 co-mutation, ELN 2022 risk group, FLT3-ITD MRD by NGS before and after transplant, Karyotype.

Scans and tests linked to this cancer: NGS-based MRD (clonoSEQ and molecular MRD).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call