What does minimal residual disease (MRD) suggest in the prognosis of acute lymphoblastic leukemia (ALL)?

Updated: Jul 17, 2018
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Case-specific molecular probes or multiparametric flow cytometry can be used to detect 1 leukemic cell in 10,000 mononuclear cells (ie, sensitivity of >104). The presence of such minimal residual disease (MRD) after treatment is a strong predictor for relapse.

A meta-analysis of 39 trials of ALL treatment of children and adults demonstrated that the event-free survival (EFS) hazard ratio for achieving MRD negative status after therapy was 0.23 for pediatric patients and 0.28 for adults. [14]  The hazard ratio for overall survival was 0.28 for both patient populations. The effect was seen across therapies, disease subtypes and methods of detection.


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