{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:24:25Z","timestamp":1794029065026,"version":"4.8.0"},"reference-count":24,"publisher":"American Society of Hematology","issue":"19","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,8]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>BMT CTN (Blood and Marrow Transplant Clinical Trials Network) 1506 (\u201cMORPHO\u201d) was a randomized study of gilteritinib compared with placebo as maintenance therapy after hematopoietic cell transplantation (HCT) for patients with FLT3-ITD\u2013mutated acute myeloid leukemia (AML). A key secondary end point was to determine the impact on survival of before and\/or after HCT measurable residual disease (MRD), as determined using a highly sensitive assay for FLT3-ITD mutations. Generally, gilteritinib maintenance therapy was associated with improved relapse-free survival (RFS) for participants with detectable peri-HCT MRD, whereas no benefit was evident for those lacking detectable MRD. We conducted a post hoc analysis of the data and found that the level of MRD detected with this approach correlated remarkably with RFS and relapse risk, and that MRD detectable at any level negatively affected RFS. In the placebo arm, 42.2% of participants with detectable FLT3-ITD MRD relapsed compared with 13.4% of those without detectable MRD. We found that 14.8% of participants had multiple FLT3-ITD clones detected as MRD and had worse survival irrespective of treatment arm. Finally, we examined the kinetics of FLT3-ITD clonal relapse or eradication and found that participants on the placebo arm with detectable MRD relapsed rapidly after HCT, often within a few weeks. MRD-positive participants on the gilteritinib arm relapsed either with FLT3 wild-type clones (assessed by capillary electrophoresis), after cessation of gilteritinib with persistent MRD, or on progression of multiclonal disease. These data demonstrate the potential of FLT3-ITD MRD to guide therapy with gilteritinib for this subtype of AML. This trial was registered at www.clinicaltrials.gov as #NCT02997202.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1182\/blood.2024025154","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T16:37:17Z","timestamp":1736267837000},"page":"2138-2148","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":68,"title":["Measurable residual disease and posttransplantation gilteritinib maintenance for patients with\n                    <i>FLT3-ITD<\/i>\n                    \u2013mutated AML"],"prefix":"10.1182","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0473-6982","authenticated-orcid":false,"given":"Mark J.","family":"Levis","sequence":"first","affiliation":[{"name":"1Division of Hematologic Malignancies and Bone Marrow Transplant, Department of Oncology, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-510X","authenticated-orcid":false,"given":"Mehdi","family":"Hamadani","sequence":"additional","affiliation":[{"name":"2Division of Hematology and Oncology, Department of Medicine, Center for International Blood and Marrow Transplant Research\/Medical College of Wisconsin, Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent R.","family":"Logan","sequence":"additional","affiliation":[{"name":"2Division of Hematology and Oncology, Department of Medicine, Center for International Blood and Marrow Transplant Research\/Medical College of Wisconsin, Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Jones","sequence":"additional","affiliation":[{"name":"1Division of Hematologic Malignancies and Bone Marrow Transplant, Department of Oncology, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag K.","family":"Singh","sequence":"additional","affiliation":[{"name":"3Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas, Kansas City, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-6302","authenticated-orcid":false,"given":"Mark R.","family":"Litzow","sequence":"additional","affiliation":[{"name":"4Division of Hematology and Transplant Center, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Wingard","sequence":"additional","affiliation":[{"name":"5Department of Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-1861","authenticated-orcid":false,"given":"Esperanza B.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"6Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1463-2231","authenticated-orcid":false,"given":"Alexander E.","family":"Perl","sequence":"additional","affiliation":[{"name":"7Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Soiffer","sequence":"additional","affiliation":[{"name":"8Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-6213","authenticated-orcid":false,"given":"Celalettin","family":"Ustun","sequence":"additional","affiliation":[{"name":"9Division of Hematology Oncology and Cell Therapy, Rush University Medical Center, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-1976","authenticated-orcid":false,"given":"Masumi Ueda","family":"Oshima","sequence":"additional","affiliation":[{"name":"10Cancer Research Division, Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7809-0996","authenticated-orcid":false,"given":"Geoffrey L.","family":"Uy","sequence":"additional","affiliation":[{"name":"11Department of Medicine, Washington University, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0816-6729","authenticated-orcid":false,"given":"Edmund K.","family":"Waller","sequence":"additional","affiliation":[{"name":"12Department of Hematology and Medical Oncology, Emory University, Atlanta, 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Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4098-3366","authenticated-orcid":false,"given":"Hee-Je","family":"Kim","sequence":"additional","affiliation":[{"name":"17Catholic Hematology Hospital, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9331-5145","authenticated-orcid":false,"given":"Matthias","family":"Stelljes","sequence":"additional","affiliation":[{"name":"18Department of Medicine\/Hematology and Oncology, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8910-0021","authenticated-orcid":false,"given":"Yuho","family":"Najima","sequence":"additional","affiliation":[{"name":"19Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome 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