Measurable Residual FLT3-ITD before Allogeneic Transplant for Acute Myeloid Leukemia

Question: Are different levels of acute myeloid leukemia (AML) measurable residual disease (MRD) prior to allogeneic hematopoietic cell transplant (HCT) associated with different posttransplant clinical outcomes? Findings: In this cohort study including 537 patients, adults with AML in first remission prior to allogeneic HCT with persistence of FLT3 internal tandem duplication (ITD) at a variant allele fraction of 0.01% or higher had increased relapse and death compared with those with lower levels detected. Patients with no detectable FLT3-ITD had the best outcomes. Meaning: In this study, for adults with FLT3-ITD AML, there was a dose-dependent correlation between pretransplant level of persistent FLT3-ITD MRD and clinical outcomes.