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In acute myeloid leukemia (AML), molecular response assessment and sequential follow-up by real-time quantitative PCR (RT-qPCR) during remission are routinely used in patients with NPM1 mutations ( NPM1 mut ), RUNX1::RUNX1T1 , or CBFB::MYH11 transcripts 1 , 2 . Even though patients who achieve complete molecular response have a better prognostic and can be cured without transplantation, they should be closely monitored according to ELN MRD guidelines since up to 30% of them may present MRD relapse (MRD Rel ) 3 . Recent retrospective studies showed that NPM1 mut or CBF-AML patients who received preemptive therapy at time of MRD Rel had a better overall survival (OS) than those treated for morphologic relapse 4 , 5 . However, there is no consensus on the best treatment approach in this situation. Preliminary studies have shown promising results with venetoclax–based low intensity therapies for both molecular failure and MRD Rel in NPM1 mut and CBFB::MYH11 AML 6 , 7 , 8 .
Higué et al. (Thu,) studied this question.