Next-generation sequencing directs therapy and delineates a clonal relationship in mast cell sarcoma and acute myeloid leukemia

A 61-year-old man was diagnosed with acute myeloid leukemia (AML) associated with trisomy 8 cytogenetic abnormality and FLT3 ITDmutation. He was induced into remission with chemotherapy, then underwent allogeneic hematopoietic stem-cell transplantation (SCT) from an HLA-matched sibling male donor. Post-transplantation, he showed no morphologic or flow cytometric evidence of disease and his bone marrow chimerism was more than 95%donor cells at several timepoints post-transplantation, including 24 months after the transplant. He received tacrolimus post-transplantation and developed mild chronic graft-versus-host disease that was limited to the skin. The patient remained on tacrolimus.