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    Displaying results 21 - 40 of 113
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This review article presents "the work of an international, multidisciplinary, 174-member panel convened to identify critical questions on key issues pertaining to MRD in chronic lymphocytic leukemia, review evaluable data, develop unified answers in conjunction with local expert input, and provide recommendations for future studies. Recommendations are presented regarding methodology for MRD determination, assay requirements and in which tissue to assess MRD, timing and frequency of assessment, use of MRD in clinical practice versus clinical trials, and the future usefulness of MRD assessment.
Detection of MRD in CLL is becoming increasingly important as treatments improve...There was good correlation between four-CLR and six-CLR panels in dilution studies and clinical samples, with 100% concordance for detection of residual disease at the 0.01% (10?4) level (n=59) and good linearity even at the 0.001�0.01% (10?5�10?4) level. A six-CLR panel therefore provides equivalent results to the four-CLR panel but it requires fewer reagents, fewer cells and a much simpler analysis approach.
In CLL the level of MRD after therapy is an independent predictor of outcome�A parallel analysis of high-throughput sequencing using the ClonoSEQ assay showed good concordance with flow cytometry results at the 0.010% (10(-4)) level, the MRD threshold defined in the 2008 International Workshop on CLL guidelines, but it also provides good linearity to a detection limit of 1 in a million (10(-6)). The combination of both technologies would permit a highly sensitive approach to MRD detection while providing a reproducible and broadly accessible method to quantify residual disease and optimize treatment in CLL.
The landscape of multiple myeloma has changed considerably in the past two decades regarding new treatments, insight into disease biology and innovation in the techniques available to assess MRD as the most accurate method to evaluate treatment efficacy. The sensitivity and standardization achieved by these techniques together with unprecedented rates of CR induced by new regimens, raised enormous interest in MRD as a surrogate biomarker of patients� outcome and endpoint in clinical trials. By contrast, there is reluctance and general lack of consensus on how to use MRD outside clinical trials. Here, we discuss critical aspects related with the implementation of MRD in clinical practice.
We review the data supporting MRD testing as well as its limitations and how it may fit in with current and future clinical practice.
This review examines the different methods used to detect MRD and discusses future considerations regarding the implementation in day-to-day clinical practice and as a prospective primary endpoint for clinical trials.
Based on available evidence correlating attainment of MRD negativity with outcomes, MRD assessment has been incorporated into ongoing clinical trials. Analyses will provide additional insight into the correlation between MRD and outcome. This monograph examines the available trial data and provides recommendations on how to incorporate MRD assessment into clinical management.
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 multiple myeloma. (Create a free account profile to access guidelines.)
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 acute leukemia and included some discussion points according to clinical practice and updated literature.
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 following is a list of facilities that are CLIA-certified and accept external MRD samples. Amgen neither recommends nor endorses, and may or may not have financial relationships with, any facility that appears on this list. This list is not intended to be a comprehensive list nor as a referral to any provider listed. If you would like to suggest a facility to be added to this list, please contact Amgen MedInfo at 800-77-AMGEN.
The International Myeloma Working Group has defined new response categories of minimal residual disease negativity, with or without imaging-based absence of extramedullary disease, to allow uniform reporting within and outside clinical trials. In this Review, we clarify several aspects of disease response assessment, along with endpoints for clinical trials, and highlight future directions for disease response assessments.
"From doctors to patients, the goal of these publications is to help anyone better understand aspects of myeloma. The information provided in the International Myeloma Working Group�s publications seeks to help guide patients and their doctors to treating myeloma in the most effective way for every individual case."
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