MRD conversion confers inferior survival compared with sustained MRD negativity. (A) OS of patients with MRD conversion is worse compared with patients with sustained MRD negativity (HR, 1.7; 95% CI, 1.1-1.7, P = .01). (B) PFS of patients with MRD conversion vs patients with sustained MRD negativity is significantly inferior (HR, 18.9; 95% CI, 13.2-27.0, P < .0001). In a landmark analysis at 3 years post-ASCT, (C) OS was significantly worse for patients that converted from MRD⁻ to -positive compared with patients with sustained MRD negativity (HR, 20.0; 95% CI, 6.3-63.0, P < .0001). (D) PFS of patients with MRD conversion is significantly worse than patients with sustained MRD negativity (HR, 4.5; 95% CI, 4.3-33.7, P < .0001). Upper and lower bands represent 95% CI.