Minimal Residual Disease Assessment in CLL/SLL: Is It Ready for Routine Clinical Practice?
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Minimal residual disease (MRD) in chronic lymphocytic leukemia (CLL) is defined as <1 CLL cell per 10,000 leukocytes (0.01%; <10−4). Flow cytometry and next-generation sequencing have demonstrated high sensitivity in MRD detection. MRD assessment may help to determine prognosis after fixed-duration regimens; this has been established in the contexts of chemoimmunotherapy and venetoclax/antibody combinations. In the short term, MRD status does not seem to inform prognosis in patients treated with a BTK inhibitor plus venetoclax-based regimens; however, long-term data will be needed to determine whether it is beneficial in this population. Numerous trials have demonstrated that MRD may be used to guide therapy. It is unclear whether using an MRD-guided treatment strategy is better than using fixed-duration therapy; ongoing and future studies are warranted.
Disclosures: Dr. Woyach has disclosed receiving consulting fees from AbbVie, Inc., AstraZeneca Pharmaceuticals LP, BeiGene, Eli Lilly and Company, Janssen Pharmaceutica Products, LP, and Pharmacyclics; receiving grant/research support from AbbVie, Inc., Janssen Pharmaceutica Products, LP, Karyopharm Therapeutics, MorphoSys AG, Pharmacyclics, and Schrodinger; and serving as a scientific advisor for Newave.
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