(Based on NHS England Genomic Unit Guidelines) Dillon et al

All guidance is for routine samples. If a positive/ concerning result arises on treatment- advice will be given by genomics lab as to when to send repeat sample. It is imperative the guidance is reviewed on each individual report. These document outlines only “routine” follow-up.

Hierarchy of AML MRD for intensive treatment regimens

1. Recommend molecular MRD if any of established MRD evidence based mutations identified.
2. If molecular MRD not available, cytogenetics/ FISH can be used, but this is not a ELN validated approach
3. If no molecular MRD lesion available, flow MRD should be sent.
4. In relapse (no allogenic stem cell transplant)- please send a repeat myeloid gene panel and FLT3 for analysis
5. In relapse (post allogenic stem cell transplant)- please send repeat FLT3 for analysis. DNA will be stored for a myeloid gene panel. Activation is on individual request.