Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts

Abstract: Measurable residual disease (MRD) is a powerful predictor of clinical outcomes in acute lymphoblastic leukemia (ALL). In addition to its clear prognostic importance, MRD information is increasingly used in clinical decision algorithms to guide therapeutic interventions. Although it is well...

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Main Authors: Nicholas J. Short, Ibrahim Aldoss, Daniel J. DeAngelo, Marina Konopleva, Jessica Leonard, Aaron C. Logan, Jae Park, Bijal Shah, Wendy Stock, Elias Jabbour
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952925000503
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author Nicholas J. Short
Ibrahim Aldoss
Daniel J. DeAngelo
Marina Konopleva
Jessica Leonard
Aaron C. Logan
Jae Park
Bijal Shah
Wendy Stock
Elias Jabbour
author_facet Nicholas J. Short
Ibrahim Aldoss
Daniel J. DeAngelo
Marina Konopleva
Jessica Leonard
Aaron C. Logan
Jae Park
Bijal Shah
Wendy Stock
Elias Jabbour
author_sort Nicholas J. Short
collection DOAJ
description Abstract: Measurable residual disease (MRD) is a powerful predictor of clinical outcomes in acute lymphoblastic leukemia (ALL). In addition to its clear prognostic importance, MRD information is increasingly used in clinical decision algorithms to guide therapeutic interventions. Although it is well established that achievement of MRD-negative remission is an important end point of ALL therapy, the prognostic and therapeutic implications of MRD in an individual patient are influenced by both disease-related factors (eg, cytomolecular risk) and assay-related factors (eg, sensitivity, specimen source, and timing of assessment), which add complexity to MRD-guided treatment decisions. In this review, we discuss the data supporting the use of MRD assessment in adult ALL and how this information can rationally inform clinical decisions, including selection of patients for MRD-directed therapies or allogeneic hematopoietic stem cell transplantation. We also discuss important interpretative challenges related to novel high sensitivity next-generation sequencing–based MRD assays, which are becoming increasingly used in clinical practice.
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spelling doaj-art-ecf74abc984c41dd915502e3f53f7ecb2025-08-20T02:07:40ZengElsevierBlood Advances2473-95292025-03-01961442145110.1182/bloodadvances.2024015441Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US expertsNicholas J. Short0Ibrahim Aldoss1Daniel J. DeAngelo2Marina Konopleva3Jessica Leonard4Aaron C. Logan5Jae Park6Bijal Shah7Wendy Stock8Elias Jabbour9Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX; Correspondence: Nicholas J. Short, Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 428, Houston, TX 77030;Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CADepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MADepartment of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NYDivision of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, ORDivision of Hematology, Blood and Marrow Transplantation, and Cellular Therapy, Department of Medicine, University of California San Francisco, San Francisco, CAMemorial Sloan Kettering Cancer Center, New York, NYDepartment of Malignant Hematology, Moffitt Cancer Center, Tampa, FLDepartment of Medicine Section of Hematology-Oncology, University of Chicago, Chicago, ILDepartment of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TXAbstract: Measurable residual disease (MRD) is a powerful predictor of clinical outcomes in acute lymphoblastic leukemia (ALL). In addition to its clear prognostic importance, MRD information is increasingly used in clinical decision algorithms to guide therapeutic interventions. Although it is well established that achievement of MRD-negative remission is an important end point of ALL therapy, the prognostic and therapeutic implications of MRD in an individual patient are influenced by both disease-related factors (eg, cytomolecular risk) and assay-related factors (eg, sensitivity, specimen source, and timing of assessment), which add complexity to MRD-guided treatment decisions. In this review, we discuss the data supporting the use of MRD assessment in adult ALL and how this information can rationally inform clinical decisions, including selection of patients for MRD-directed therapies or allogeneic hematopoietic stem cell transplantation. We also discuss important interpretative challenges related to novel high sensitivity next-generation sequencing–based MRD assays, which are becoming increasingly used in clinical practice.http://www.sciencedirect.com/science/article/pii/S2473952925000503
spellingShingle Nicholas J. Short
Ibrahim Aldoss
Daniel J. DeAngelo
Marina Konopleva
Jessica Leonard
Aaron C. Logan
Jae Park
Bijal Shah
Wendy Stock
Elias Jabbour
Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
Blood Advances
title Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
title_full Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
title_fullStr Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
title_full_unstemmed Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
title_short Clinical use of measurable residual disease in adult ALL: recommendations from a panel of US experts
title_sort clinical use of measurable residual disease in adult all recommendations from a panel of us experts
url http://www.sciencedirect.com/science/article/pii/S2473952925000503
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