Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 19:12:7-16.
doi: 10.2147/BLCTT.S270134. eCollection 2022.

Clinical Value of Measurable Residual Disease in Acute Lymphoblastic Leukemia

Kyaw Hein  1 , Nicholas Short  1 , Elias Jabbour  1 , Musa Yilmaz  1
Affiliations
Review

Clinical Value of Measurable Residual Disease in Acute Lymphoblastic Leukemia

Kyaw Hein et al. Blood Lymphat Cancer. .

Abstract

Measurable (minimal) residual disease (MRD) status in acute lymphoblastic leukemia (ALL) has largely superseded the importance of traditional risk factors for ALL, such as baseline white blood cell count, cytogenetics, and immunophenotype, and has emerged as the most powerful independent prognostic predictor. The development of sensitive MRD techniques, such as multicolor flow cytometry (MFC), quantitative polymerase chain reaction (PCR), and next-generation sequencing (NGS), may further improve risk stratification and expand its impact in therapy. Additionally, the availability of highly effective agents for MRD eradication, such as blinatumomab, inotuzumab ozogamicin, and chimeric antigen receptor (CAR) T-cell therapies, enabled the development of frontline regimens capable of eradicating MRD early in the treatment course. While long-term follow-up of this approach is lacking, it has the potential to significantly reduce the need for intensive post-remission treatments, including allogeneic bone marrow transplantation, in a significant proportion of patients with ALL.

Keywords: acute lymphoblastic leukemia; minimal residual disease; multicolor flow cytometry; next-generation sequencing; polymerase chain reaction.

PubMed Disclaimer

Conflict of interest statement

Dr Nicholas Short reports Research Support from Takeda Oncology, Stemline Therapeutics, and Astellas, Consultant and Speaker’s Bureau from Amgen, being a Consultant for AstraZeneca, fNGMBio, Novartis, and Pfizer, and receiving a Grant from fNGMBio outside the submitted work. Dr Elias Jabbour reports grants, personal fees from Amgen, grants, personal fees from Adaptive biotechnologies, grants, personal fees from Pfizer, grants, personal fees from Takeda, during the conduct of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Measurable Residual Disease Assessment Methods.
See this image and copyright information in PMC

References

    1. Abou Dalle I, Jabbour E, Short NJ. Evaluation and management of measurable residual disease in acute lymphoblastic leukemia. Ther Adv Hematol. 2020;11:204062072091002. doi:10.1177/2040620720910023 - DOI - PMC - PubMed
    1. Bassan R, Spinelli O, Oldani E, et al. Improved risk classification for risk-specific therapy based on the molecular study of minimal residual disease (MRD) in adult acute lymphoblastic leukemia (ALL). Blood. 2009;113(18):4153–4162. doi:10.1182/blood-2008-11-185132 - DOI - PubMed
    1. Gökbuget N, Kneba M, Raff T, et al. Adult patients with acute lymphoblastic leukemia and molecular failure display a poor prognosis and are candidates for stem cell transplantation and targeted therapies. Blood. 2012;120(9):1868–1876. doi:10.1182/blood-2011-09-377713 - DOI - PubMed
    1. Jacquy C, Delepaut B, Van Daele S, et al. A prospective study of minimal residual disease in childhood B-lineage acute lymphoblastic leukaemia: MRD level at the end of induction is a strong predictive factor of relapse. Br J Haematol. 1997;98(1):140–146. doi:10.1046/j.1365-2141.1997.1792996.x - DOI - PubMed
    1. Cazzaniga G, Biondi A. Molecular monitoring of childhood acute lymphoblastic leukemia using antigen receptor gene rearrangements and quantitative polymerase chain reaction technology. Haematologica. 2005;90(3):382–390. - PubMed