Photo Credit: Nemes Laszlo
A Panel of 10 Expert Hematologists Created Recommendations for Optimal MRD-Gueded All Treatment, Which Were Recently Published In Blood Advances.
When acute lymphoblastic leukemia (ALL) Occurs in adult patients, Studies have shown that the must complling prognostic tool is residual measurable dissease (MRD). MRD Assessment is consistently accurate in its predictive application across all subtypes, the Timing of MRD Assessment, Varying Clinical Contexts, and the Specific Type of MRD Assay Applied.
Redin the confirmed value of MRD, many questions remain regarding its use, including variation among assays, cytomolecular features, and potential therapeutic interactions. To address these and other issues regarding the use of mrd as a prognostic tool in all, a panel of 10 experts in the field was assembly and tasked with developing recommands regar the optimal use of mrd in adults with all. The Results of this collaboration were published in Blood Advances.
Before The Panel’s Work Commenced, A Systematic Literature Review Targeting Retrospective and Prospective English Studies on MRD and All Was Used to Development The Questions To Be Focused On By The Panel. One of the Panelists, Nicholas Short, MD, Discussed The Findings and Recommendations of This Group of Experts with Physician’s Weekly (PW).
PW: What Challenges Exist In Using MRD Assessment to Guide DECISION-MAKING IN ALL?
Dr. Short: MRD Assessment is critical to risk in all. However, The Literature Lacked Guidance on How This Information Should inform therapeutic Decision-MAKING, Such AS selecting Patients for Allogeneic Stem Cell Transplantation. The Recent Development of Very High-Sensitivity MRD Assays (Such As the Next-Gegeration Seicncing-Based CLONOSEQ Assay) has complicated these issues since they are fewer published studies describing the dynamics of mRD Using this assay and how very low levels of mrd detected by clonoseq should informment treatment decisions.
What are the show Important Recommendations Developed by the panel?
The Panel Recommends That Most Clinical Decision-Making Should Be Based on Clonoseq Testing, Which is the Most Sensitive MRD Assay We Have For All. We also Provided Guidance for the Optimal Frequency of MRD Testing in All, the use of Blood Bone Marrow MRD Assessment, and How This Information Can Inform Decisions for Allogeneic Cell Transplantation or MRD-Directed Therapies.
What Knowledge Gaps Remain Regarding MRD Use During All Treatment?
Large Prospective Studies Are Needed to Better Understand The Dynamics of MRD Across Novels Being Developed for Patients with All (EG, Regimens that Incorporate blrinatumomab, Inotuzumab ozogamicinand/or CAR T-Cells) So that these rewards can be refined in the future. We have date on when on when the achievement of Deep MRD negativity Using the clonoseq assay may overcome the poor pronis of paters with high-teromolecular features and the impact of ngs-based MRD clononoseq in t-cell all, among missing among questions.
What else Should Clinicians Know About Using The Clonoseq Assay?
AN IMPORTANT SECTION OF THESE REPROMENS FOCUSED ON Interpretation Clonoseq Results, Which Can Be Challenging. Proper Interpretation of this Assay (Which is Now Becoming the Most Common Way to Assess MRD in All in the US) is Imperative To Avoid Overtreating A Patient with “False Positive” MRD Results.
