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MRD in ALL: Optimization and Innovations

  • ACUTE LYMPHOCYTIC LEUKEMIA (R. MESA, SECTION EDITOR)
  • Published:
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Abstract

Purpose of Review

Measurable residual disease (MRD) is an important monitoring parameter that can help predict survival outcomes in acute lymphoblastic leukemia (ALL). Identifying patients with MRD has the potential to decrease the risk of relapse with the initiation of early salvage therapy and to help guide decision making regarding allogeneic hematopoietic cell transplantation. In this review, we discuss MRD in ALL, focusing on advantages and limitations between MRD testing techniques and how to monitor MRD in specific patient populations.

Recent Findings

MRD has traditionally been measured through bone marrow samples, but more data for evaluation of MRD via peripheral blood is emerging. Current and developmental testing strategies for MRD include multiparametric flow cytometry (MFC), next-generation sequencing (NGS), quantitative polymerase chain reaction (qPCR), and ClonoSeq. Novel therapies are incorporating MRD as an outcome measure to demonstrate efficacy, including blinatumomab, inotuzumab ozogamicin, and chimeric antigen receptor T (CAR-T) cell therapy.

Summary

Understanding how to incorporate MRD testing into the management of ALL could improve patient outcomes and predict efficacy of new therapy options.

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology and Oncology, University of Virginia Comprehensive Cancer Center, 1300 Jefferson Park Ave, PO Box 800716, Charlottesville, VA, 22908, USA

    Eric Pierce, Benjamin Mautner, Joseph Mort, Michael Keng & Firas El Chaer

  2. Department of Pharmacy Services, University of Virginia Comprehensive Cancer Center, 1300 Jefferson Park Ave, PO Box 800716, Charlottesville, VA, 22908, USA

    Anastassia Blewett & Amy Morris

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  1. Eric Pierce
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Pierce, E., Mautner, B., Mort, J. et al. MRD in ALL: Optimization and Innovations. Curr Hematol Malig Rep 17, 69–81 (2022). https://doi.org/10.1007/s11899-022-00664-6

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