Clinical Value of Measurable Residual Disease in Acute Lymphoblastic Leukemia

Abstract

Kyaw Hein, Nicholas Short, Elias Jabbour, Musa Yilmaz Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USACorrespondence: Musa Yilmaz, Department of Leukemia, MD Anderson Cancer Center, University of Texas, 1400 Holcombe Blvd., Unit 428, Houston, TX, 77030, USA, Tel [phone], Fax [phone], Email [email protected]: Measurable (minimal) residual disease (MRD) status in acute lymphoblastic leukemia (ALL) has largely superseded the importance of traditional risk factors for ALL, such as baseline white blood cell count, cytogenetics, and immunophenotype, and has emerged as the most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, polymerase chain reaction, next-generation sequencing

Keywords

• acute lymphoblastic leukemia
• minimal residual disease
• multicolor flow cytometry
• polymerase chain reaction
• next-generation sequencing