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MRD is an established and sensitive prognostic tool to assess the depth of response during and after treatment of chronic lymphocytic leukemia CLL and to understand disease dynamics after treatment. Retracing these kinetics is paramount to understand which group of patients is at risk of relapsing despite initial MRD response. To this end, we here provide an analysis of clonal growth patterns in patients treated within the CLL14 trial.
Blood
To identify complementary markers suitable for further treatment stratification in SR ALL, the study evaluated the predictive value of MRD and prospectively monitored MRD in 196 strictly defined SR ALL patients at up to 9 time points in the first year of treatment by quantitative polymerase chain reaction (PCR).
Blood
Among adults with MRD-positive ALL in hematologic remission after chemotherapy, 78% achieved a complete MRD response with blinatumomab...Complete MRD response after blinatumomab treatment in this population was associated with significantly improved OS.
Blood
In this review article, we outlined the major clinical trials that have determined the prognostic value of MRD in MM. We also reviewed different methods that were used for MM MRD assessment. Most important, we reviewed our current understanding of MM MRD biology.
Biomarker Research
The primary cause of poor outcome following allogeneic HCT for CLL is disease recurrence. Detection of increasing MRD following HCT may permit early intervention to prevent clinical relapse; however, MRD quantification remains an uncommon diagnostic test because of logistical and financial barriers to widespread use. Here we describe a method for quantifying CLL MRD using widely available consensus primers for amplification of all Ig heavy chain (IGH) genes in a mixture of peripheral blood mononuclear cells, followed by high-throughput sequencing for disease-specific IGH sequence quantification.
Biological Sciences
In both children and adults with ALL, MRD testing as early as induction therapy has been shown to have prognostic significance.
Amgen
NCCN offers clinical guidelines to guide the treatment and care of patients with multiple myeloma. (Create a free account profile to access guidelines.)
National Comprehensive Cancer Network (NCCN)
NCCN offers clinical guidelines to guide the treatment and care of patients with CLL. (Create a free account profile to access guidelines.)
National Comprehensive Cancer Network (NCCN)
NCCN offers clinical guidelines to guide the treatment and care of patients with ALL. (Create a free account profile to access guidelines.)
National Comprehensive Cancer Network (NCCN)
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.
Journal of Clinical Oncology
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.
Cancer Care Ontario
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.
Archives of Pathology & Laboratory Medicine
This handout provides an overview of MRD for individuals with blood cancer.
The Leukemia and Lymphoma Society (LLS)
This Fact Sheet for healthcare professionals will explain the methods currently used for MRD assessment, how and when testing should occur for different hematologic malignancies, and how the resulting information can inform prognosis and decisions about care.
The Leukemia and Lymphoma Society (LLS)
This handout provides an overview of cancer molecular profiling and its implications in the treatment of blood cancer.
The Leukemia and Lymphoma Society (LLS)
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.
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.
The Lancet Oncology
"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."
International Myeloma Foundation (IMF)
Recent advances including the discovery of the genomic landscape of the disease, the development of genetic tests with prognostic relevance, and the detection of minimal residual disease (MRD), coupled with the increased availability of novel targeted agents with impressive efficacy, prompted an international panel to provide updated evidence- and expert opinion�based recommendations. These recommendations include a revised version of the iwCLL response criteria, an update on the use of MRD status for clinical evaluation, and recommendations regarding the assessment and prophylaxis of viral diseases during management of CLL.
Blood
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.
Multiple Myeloma Research Foundation (MMRF)