We sought to study the self-reported utilization patterns of MRD assessment in CLL and MM, it's use in determining duration of therapy, and the barriers to it's adoption in practice among U.S. cH/O...These data from a limited sample of cH/O suggest that adoption of MRD testing among US cH/O is low, despite results from recent trials that highlight the importance of the MRD negativity as an important prognostic factor in both CLL and MM. Half of cH/O do not measure MRD at any point while treating MM and CLL and less than a fifth incorporate MRD data to determine duration of therapy. The greatest barrier to MRD assessment is the impression that there is lack of evidence supporting its utility in practice at the present time. Further education among cH/O is warranted regarding MRD assessment in CLL and MM given that MRD-negative status is associated with favorable prognosis and should be incorporated in treatment decision-making based on updated guidelines in both diseases.

"This article shows that poor early MRD response, in contrast to conventional ALL risk factors, is an excellent tool to identify patients who may benefit from allogeneic SCT in the context of intensified adult ALL therapy."

NCCN offers clinical guidelines to guide the treatment and care of patients with ALL.

"These guidelines provide evidence surrounding the clinical utility of MRD testing using multiparameter flow cytometry (MFC), next-generation sequencing (NGS), or polymerase chain reaction (PCR)-based methods in patients with ALL."

"Through a review of the literature and in house data, authors analyze the current status of MRD assessment in ALL to better understand how some of its limitations could be overcome by emerging molecular technologies. Authors highlight the future role of MRD monitoring in the context of personalized protocols, taking into account the genetic complexity in ALL."

"Assessment of measurable residual disease (MRD) is rapidly transforming the therapeutic and prognostic landscape of a wide range of hematological malignancies. Its prognostic value in acute lymphoblastic leukemia (ALL) has been established and MRD measured at the end of induction is increasingly used to guide further therapy. Although MRD detectable immediately before allogeneic hematopoietic cell transplantation (HCT) is known to be associated with poor outcomes, it is unclear if or to what extent this differs with different types of conditioning."

"The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant."

"The ASCO Expert Panel determined that the recommendations from the guideline, published in 2016, are clear, thorough, and based on the most relevant scientific evidence. ASCO fully endorsed the CAP-ASH guideline on initial diagnostic work-up of AL and included some discussion points according to clinical practice and updated literature."

"This comprehensive review focuses on the recent advances and future directions in novel therapeutic strategies in adult ALL."

"In adults with relapsed/refractory ALL receiving first salvage therapy, achievement of MRD negativity is an important therapeutic outcome. Patients who achieve MRD negativity with first salvage treatment and undergo SCT have the best long-term survival."

"ALL is uniquely amenable to quantification of MRD by multiple techniques. Quantification of MRD with high-sensitivity methods not only facilitates risk stratification, but also is used to determine appropriateness of intensified therapy, such as allogeneic hematopoietic cell transplant, as well as MRD-targeted therapy with blinatumomab."

"Minimal residual disease (MRD) refers to the presence of disease in cases deemed to be in complete remission by conventional pathologic analysis. Assessing the association of MRD status following induction therapy in patients with ALL with relapse and mortality may improve the efficiency of clinical trials and accelerate drug development."

"A systematic literature review and meta-analysis were performed to elucidate the clinical significance of minimal residual disease with respect to relapse-free survival and overall survival in precursor B-cell ALL."

Health Professional Version

Health Professional Version

Find answers to some of the most commonly asked questions about multiple myeloma from nurses and patients.

Our faculty will review the importance of MRD for multiple myeloma patients and strategies to reach and stay MRD negative. This webinar will provide timely information to keep patients and caregivers up to date on the important progress being made in myeloma today, help them communicate more effectively with their health care team, and empower them to achieve the best possible outcome for their disease.

This webinar provides the multidisciplinary cancer team with important and practical information for the assessment of MRD as part of routine clinical practice for their patients with CLL. The presentation will be valuable for understanding the impact of MRD on treatment decisions and practice patterns, which has promise to lead to major improvements in outcomes for CLL patients in the very near future.

The series is designed to provide clinicians and researchers in hematology foundational information on the latest technologies available [including MRD] for data acquisition, diagnosis, and decision making for hematologic diseases.

John Gribben of Barts Cancer Institute, London, UK, chairs an insightful discussion with Barbara Eichhorst of the University of Cologne, Cologne, Germany, Susan O�Brien of the University of California, Irvine, CA, and Matthew Davids of Dana-Farber Cancer Institute, Boston, MA, on the latest CLL updates from the recent Virtual ASCO and EHA 2020 Meetings. The speakers discuss frontline therapy for CLL, BTK inhibitors, novel combination therapies and the importance of measurable residual disease (MRD) assessment. Treatment sequencing and novel therapies, in particular CAR T-cell approaches were also discussed.