Assessment of MRD is rapidly transforming the therapeutic and prognostic landscape of a wide range of hematological malignancies. Its prognostic value in 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 HCT is known to be associated with poor outcomes, it is unclear if or to what extent this differs with different types of conditioning.

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

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.

Brief review article that concludes, "With the approval of several new drugs with different mechanisms of action and the incorporation of MRD as an end-point in clinical trials, the management landscape of MM is changing rapidly. Given the significant impact of MRD negativity on the outcomes, it could be a new regulatory surrogate end-point for survival in clinical trials and a main driver of research and clinical practice in MM in the future.

This review outlines current methods of MRD detection in CLL and summarizes MRD data from relevant trials. The significance of MRD testing in clinical studies and in routine patient care is assessed and new MRD-guided treatment strategies are discussed.

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.

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.

"This monograph examines clinical trial data regarding the role of MRD in CLL, and provides recommendations on how to incorporate MRD assessment into clinical management."

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.

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.

Here, we will address the currently utilized MRD assays, challenges in validation across labs and clinical trials, techniques in development, and future directions for successful clinical application of MRD in multiple myeloma.

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.)

NCCN offers clinical guidelines to guide the treatment and care of patients with CLL. (Create a free account profile to access guidelines.)

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

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.

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.

This online, no-cost CME activity, features presentations on current and evolving MM patient care practices and discussions of how they are likely to evolve over the next 3 to 5 years.

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.