What is your general approach to post-allogeneic HSCT maintenance therapy for AML?

I use midostaurin starting 60-90 days after allogeneic transplant continued till 1 yr post transplant for patients with Flt-3 mutations. Some of my colleagues prefer sorafenib for post transplant maintenance in this setting. I have not yet started using IDH inhibitors post allogeneic transplant.

HMA...

Relapse is the most important cause of treatment failure post allo HCT. However, to date no strategy has been conclusively shown to reduce or prevent recurrence.

Having said that we approach every patient with greater than a 30% historical risk of recurrence within 2 years to consider relapse preven...