DNA sequencing to detect residual disease in adults with acute myeloid leukemia prior to hematopoietic cell transplant

Preventing relapse for adults with acute myeloid leukemia (AML) in first remission is the most common indication for allogeneic hematopoietic cell transplantation (allo-HCT). The presence of AML measurable residual disease has been associated with higher relapse rates, but testing is not standardized. A retrospective observational study at 111 US transplant centers found that among patients with AML in first complete remission prior to allo-HCT, persistence of FLT3-ITD or NPM1 variants in the blood at an allele fraction of 0.01% or higher was associated with increased risk of relapse an worse survival compared with those without variants detected.