Molecular Minimal Residual Disease in Acute Myeloid Leukemia

To the Editor: Jongen-Lavrencic and colleagues (March 29 issue) 1 highlight the clinical usefulness of a next-generation sequencing panel to identify minimal residual disease in patients with acute myeloid leukemia (AML) during complete remission. The authors found that the detection of nonclonal hematopoiesis–associated mutations (non- DTA mutations, or those not involving DNMT3A, TET2, or ASXL1 ) during complete remission predicted a poor prognosis; however, these findings are called into question by the considerable rate of false negative results of next-generation sequencing. In Figure 3 of the article, available at NEJM.org, the rate of false negative results with next-generation sequencing (i.e., a negative result . . .