‘The HemOnc Pulse Live!’: AML in Transition

Starting with a compelling overview of evolving treatment strategies and emerging challenges in the field of acute myeloid leukemia (AML), this episode was recorded during the HemOnc Pulse Live! event held earlier this year in Austin, Texas. The discussion highlights the clinical complexities of AML management in the modern era through a series of expert perspectives.

Moderator:

• • Naval Daver, MD, The University of Texas MD Anderson Cancer Center

Panelists:

• • Aditi Shastri, MBBS, Albert Einstein College of Medicine
  • Tapan M. Kadia, MD, The University of Texas MD Anderson Cancer Center
  • Kelly S. Chien, MD, The University of Texas MD Anderson Cancer Center
  • Eunice Wang, MD, Roswell Park Comprehensive Cancer Center

Dr. Wang opened the session by challenging longstanding assumptions regarding persistent mutations such as NPM1 and IDH1/2. Referencing recent data, she noted that these so-called founder mutations can be lost over the course of treatment. As targeted therapies, such as FLT3 inhibitors, become more effective, resistant clonal evolution can emerge, prompting a reevaluation of traditional molecular targets in AML.

The panel examined the role of measurable residual disease (MRD) in guiding transplant decisions, including the debate over whether MRD negativity should be a prerequisite for proceeding to transplantation. Dr. Kadia emphasized clinical flexibility, noting that transplant followed by maintenance therapy can offer benefit even in MRD-positive patients.

Audience engagement further shaped the conversation, with questions focused on the clinical implications of pursuing ultra-deep MRD thresholds. Panelists expressed concern that rigid standards may delay appropriate interventions, especially in younger patients.

The session concluded with consensus on the importance of improving coordination between leukemia and transplant teams. Emphasis was placed on case-by-case evaluation, multidisciplinary discussion, and data-informed clinical judgment as essential components of AML care moving forward.