A UC San Diego study presented at AMP 2025 found that next-generation sequencing after allogeneic stem cell transplantation may help predict which adults with acute myeloid leukemia are most likely to relapse. Among 74 patients with serial sequencing, post-transplant mutations appeared in 35 individuals, and 31 later relapsed. Persistent TET2 and DNMT3A variants showed the strongest associations with recurrence. Detectable mutations after transplant increased relapse risk more than fourfold, whereas high donor chimerism was linked to ongoing remission and likely reflected CHIP rather than residual leukemia. Combining mutation profiling with chimerism assessment may refine post-transplant monitoring and guide early intervention.