Minimal or Measurable Residual Disease in Acute Lymphoblastic Leukemia

Shilpa Paul, Caitlin Rausch, Hagop M. Kantarjian, Elias Jabbour

Research output: Chapter in Book/Report/Conference proceedingChapter


Detection of minimal or measurable residual disease (MRD) in acute lymphoid leukemia (ALL) post induction or consolidation has significant prognostic and treatment implications. Persistence of MRD has shown to confer resistance to conventional chemotherapy and predicts for early relapse; therefore, it is regarded as an independent risk factor for poor outcomes. Assessment of MRD through various methods such as multiparameter flow cytometry (MFC), polymerase chain reaction (PCR), or next-generation sequencing (NGS) is important post induction, consolidation, and various other time points in therapy, as indicated, for early therapeutic intervention. Selection of MRD assay depends on its availability and expertise with the method, although each one has its own advantages and disadvantages. Recent development of MRD-directed therapies such as blinatumomab and inotuzumab ozogamicin (InO) has placed significant value on detecting MRD through these methods, as early treatment intervention with these therapies can potentially eradicate MRD and prolong survival. This chapter reviews and compares the different MRD assays, describes the prognostic implications of MRD, and discusses MRD-directed therapies.

Original languageEnglish (US)
Title of host publicationHematologic Malignancies
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages14
StatePublished - 2021

Publication series

NameHematologic Malignancies
ISSN (Print)2197-9766
ISSN (Electronic)2197-9774

ASJC Scopus subject areas

  • Hematology
  • Oncology

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