Dr. Chao on Minimal Residual Disease in ALL

Nelson Jen An Chao, MD, professor of medicine, Donald D. and Elizabeth G. Cooke Cancer Research Professor, chief, Division of Cell Therapy in the Department of Medicine, Duke Cancer Institute, discusses minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL).

The key takeaway regarding MRD is that there are many ways to measure it. Currently, the most common means of testing for MRD is with flow cytometry, but polymerase chain reaction testing can be done as well. In terms of distinguishing between assays, it often comes down to the sensitivity, cost, expertise, and primarily accepted standards, which can vary between institution, explains Chao.

Clinical trials have shown that patients who achieve MRD negativity have better outcomes than those who are MRD-positive. However, it remains unclear how to induce MRD negativity in an MRD-positive patient, says Chao. Those studies are ongoing. Now, MRD is a “yes” or “no” question and is something that is assessed at the end of therapy.