The presence of measurable residual disease (MRD) in patients with acute myeloid leukemia (AML) is an important prognostic factor in all stages of the disease.1-5  In particular, patients in a morphologic remission who still have detectable MRD prior to allogeneic transplant have an outcome similar to patients with morphologically persistent disease pretransplant, at least when conventional polymerase chain reaction (PCR)- and flow cytometry–based techniques are used to identify MRD. However, the molecular heterogeneity of AML has rendered it challenging to develop any assay that can consistently detect residual disease, and most methods available today lack sensitivity beyond 1 cell in 100.

In the randomized trial of chemotherapy plus or minus the FLT3 inhibitor midostaurin for FLT3-mutant AML (CALGB10603/RATIFY), patients who underwent allogeneic transplant in remission after treatment with chemotherapy plus midostaurin had a markedly better outcome posttransplant...

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