The Use of Next-Generation Sequencing (NGS) in Acute Myeloid Leukemia Survey

Dear Colleagues,

This IACH survey aims to evaluate the current implementation of next-generation sequencing (NGS) in the management of AML in your center. Your input will help us understand existing practices, the impact of NGS on clinical decision-making, and potential areas for improvement. The survey should take approximately 5 minutes to complete. Your responses will remain confidential.

30 survey responders will win free registrations and a 300 Euro travel grant to the 8th Annual Meeting of IACH taking part with COMydAL, COLYM and MPNCo&D in Paris France this October.

Thank you, and best wishes,

Prof. Mohamad Mohty

On behalf of the IACH Scientiﬁc Steering Committee

2.How many years of experience do you have in the field of AML diagnosis and treatment?(Required.)

< 5 years

5 - 10 years

11 - 20 years

> 20 years

3.Do you have personally specific expertise in NGS interpretation?(Required.)

Yes, I actively interpret NGS results

Yes, but only for research purposes

No, but I use NGS results for decision-making

No, I do not directly engage with NGS data and rely on the laboratory team

4.Do you collaborate with a molecular diagnostics team for NGS-based decision-making?(Required.)

Yes, regularly

Yes, occasionally

No, I interpret results independently

5.In which country is your center located?

6.What is the annual number of AML patients treated at your center?(Required.)

< 50

50 - 100

101 - 200

>200

7.What is the size of your hospital?(Required.)

Small (< 200 beds)

Medium (200 - 500 beds)

Large (> 500 beds)

8.Where is your center located?(Required.)

Public general hospital

Private clinic/hospital

Academic/university hospital

Other (please specify)

9.Does your center routinely perform NGS for AML patients at diagnosis?(Required.)

Yes, for all AML patients

No, we do not use NGS for AML diagnosis

Yes, but only for selected AML cases (Please specify: intermediate/high-risk, normal cytogenetics, relapse, etc.)

10.At which time points is NGS performed in your center? (Select all that apply)(Required.)

At diagnosis

During measurable residual disease (MRD) assessment (see footnotes)

At relapse

Never performed

During follow-up/other (please specify)

11.How does NGS influence therapeutic decision-making in your center? (Select all that apply)(Required.)

Yes, it guides the use of targeted therapies (e.g., FLT3 inhibitors)

Yes, it guides other targeted therapies (e.g., IDH inhibitors)

Yes, it influences allogeneic stem cell transplantation (allo-HCT) indications

Yes, it is used for risk stratification (without directly altering treatment decisions)

No, NGS results do not significantly impact management

Other (please specify)

12.Is NGS used for measurable residual disease (MRD) monitoring in your center?(see footnotes)(Required.)

Yes, routinely

Yes, but only in the context of clinical trials

No, we use alternative MRD techniques (e.g., flow cytometry, PCR)

No, MRD is not routinely monitored

13.Where is NGS performed for AML patients at your center?(Required.)

In-house (within the hospital/laboratory)

At an external reference laboratory

Both in-house and external laboratories, depending on availability

15.Which NGS panel is most commonly used in your center for AML?(Required.)

Limited Myeloid-specific panel (CEBPA, FLT3, IDH1, IDH2, KIT, KRAS, NPM1, NRAS, RUNX1, and TP53)

Myeloid-specific panel including all mutations listed in ELN 2022 classification (CEBPA, DNMT3A, FLT3, IDH1, IDH2, KIT, KRAS, NPM1, NRAS, RUNX1, TP53, ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, or ZRSR2).2

Extensive myeloid-specific panel including additional mutations not listed in the ELN 2022 classification.

We do not perform NGS for AML

Other (please specify)

16.How frequently do NGS results lead to a change in patient management?(Required.)

17.What are the main limitations of implementing NGS in your center? (Select all that apply)(Required.)

Cost and reimbursement issues

Long turnaround time

Lack of expertise in result interpretation

Limited availability of targeted therapies based on NGS findings

Logistical or infrastructural challenges

Other (please specify)

18.Would your center be interested in participating in an initiative to harmonize the use of NGS in AML?(Required.)

Yes

No

May be, depending on the project details

19.Additional Comments: (Please provide any further thoughts or suggestions regarding the use of NGS in AML in your center.)

20.To be eligible to win one of 30 free registrations and a 300 Euro travel grant to the 8th Annual Meeting of IACH taking part with COMydAL, COLYM and MPNCo&D in Paris France, please provide your email.

Footnotes:

References:

1. Heuser M, Freeman SD, Ossenkoppele GJ, Buccisano F, Hourigan CS, Ngai LL et al. 2021 Update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD Working Party. Blood 2021; 138(26): 2753-2767. doi: 10.1182/blood.2021013626

2. Döhner H, Wei AH, Appelbaum FR, Craddock C, DiNardo CD, Dombret H et al. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood 2022; 140(12): 1345-1377. e-pub ahead of print 2022/07/08; doi: 10.1182/blood.2022016867