ESH AL 2018 | MRD to determine risk of relapse after induction in AML

It was I think, John Goldman and Robert Gale who encouraged us to use the phrase measurable residual disease rather minimal residual disease, makes much more sense, and that, as you properly say now, is becoming widely adopted. The strategies for detecting MRD are, at the moment, either immunophenotypic or molecular using PCR-based strategies, or some very interesting data with the next-generation sequencing, and it’s proving real importance in terms of stratifying patients, in terms of risk of relapse after induction chemotherapy.

So, Sylvie Freeman’s work after a couple of courses of induction, showing that you can identify patients with a really quite low risk of relapse on the basis of MRD says it’s very important in terms of identifying subsequent treatment and it’s also going to be very valuable if confirmed in prospective studies in the setting of identifying patients who after transplant require additional strategies to reduce the risk of disease recurrence. So, ensuring that we have reliable approaches, reproducible approaches towards measuring MRD, defining the time points that inform treatment choice, is obviously going to have a really important role in whether patients are treated just with chemo or whether they go to transplant, and if they go to transplant how we transplant them, and then finally it’s increasingly clear this is a very interesting tool to embed in early phase trials of novel agents to get an early readout of activity.