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Minimal Residual Disease Monitoring in Adult ALL to Determine Therapy

  • Acute Lymphocytic Leukemias (F Ravandi, Section Editor)
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Abstract

Almost 90 % of children and 50 % of adults with acute lymphoblastic leukemia (ALL) are cured by modern treatment regimens, with significant variations due to several disease- and host-related characteristics. The attainment of an early remission and the avoidance of relapse and treatment-related mortality are the fundamental therapeutic steps. In remission patients, the assessment of the disease response to early intensive therapy through the detection and monitoring of minimal residual disease (MRD) can accurately refine the individual prognosis and is increasingly used to support a risk-oriented treatment strategy. In this way, only the patients with an unfavorable MRD response are preferably selected for allogeneic stem cell transplantation, irrespective of their clinical risk class. This choice spares transplant-related toxicities to MRD responsive cases. Further advancement is expected by integrating the MRD analysis with improved pediatric-type regimens and novel targeting agents for ALL subsets at higher risk of relapse.

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Dr. Renato Bassan reports personal fees from Amgen.

Dr. Orietta Spinelli declares no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. UOC Ematologia, Ospedale dell’Angelo, Via Paccagnella 11, 30174, Mestre-Venezia, Italy

    Renato Bassan

  2. Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Piazza OMS,1, 24127, Bergamo, Italy

    Orietta Spinelli

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  1. Renato Bassan
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Correspondence to Renato Bassan.

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This article is part of the Topical Collection on Acute Lymphocytic Leukemias

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Bassan, R., Spinelli, O. Minimal Residual Disease Monitoring in Adult ALL to Determine Therapy. Curr Hematol Malig Rep 10, 86–95 (2015). https://doi.org/10.1007/s11899-015-0252-7

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