Therapeutic Approaches and Clinical Outcomes of Myeloid/Lymphoid Neoplasms With Eosinophilia Harboring FLT3 Rearrangements: A Systematic Review of 39 Cases

ABSTRACT

MLN‐Eo (Myeloid/Lymphoid Neoplasms with Eosinophilia) harboring FLT3 rearrangement is an extremely rare hematologic malignancy for which standardized treatment guidelines are currently lacking. This systematic review synthesizes the largest cohort (39 cases) to date of FLT3‐ rearranged MLN‐Eo. The available evidence supports the role of hematopoietic stem cell transplantation (HSCT) as the cornerstone for achieving long‐term survival and as a potentially curative intervention under current treatment modalities. Tyrosine kinase inhibitors (TKIs) can be used as bridging therapy to transplantation by inducing remission and reducing tumor burden. For patients ineligible for HSCT, TKI‐based regimens (combined with chemotherapy) are recommended for disease control, while chemotherapy alone is strongly discouraged due to uniformly poor outcomes. These findings provide a practical treatment framework based on the currently available evidence and may help inform clinical decision‐making for this rare and challenging disease.