Posttransplantation MRD monitoring in patients with AML by next-generation sequencing using DTA and non-DTA mutations

Abstract Next-generation sequencing (NGS)-based measurable residual disease (MRD) monitoring in patients with acute myeloid leukemia (AML) is widely applicable and prognostic prior to allogeneic hematopoietic cell transplantation (alloHCT). We evaluated the role of clonal hematopoiesis–associated DNMT3A, TET2, ASXL1 (DTA) non-DTA mutations for MRD post-alloHCT refine marker selection. Of 154 AML, 138 (90%) had at least one mutation diagnosis, which were retrospectively monitored by amplicon-based error-corrected NGS on day 90 and/or 180 post-alloHCT. was detected 34 (25%). The rate positivity similar when DTA considered separately (17.6% vs 19.8%). no impact cumulative incidence relapse, relapse-free survival, or overall survival our study removed from further analysis. In remaining 131 1 mutation, clinical transplantation-associated characteristics similarly distributed between MRD-positive MRD-negative patients. multivariate analysis, an independent adverse predictor but not nonrelapse mortality. effect different cutoffs (above limit detection, 0.1% 1% variant allele frequency). log-reduction diagnosis assessment value. status strongest who positive alloHCT. conclusion, are NGS-MRD markers post-alloHCT, whereas posttransplant setting remains open.