ESH AL 2026 | Emerging technologies being explored for MRD detection in ALL: NGS & digital droplet PCR
Wendy Stock, MD, University of Chicago Medical Center, Chicago, IL, comments on novel technologies being explored for measurable residual disease (MRD) detection in acute lymphoblastic leukemia (ALL), drawing focus on next-generation sequencing (NGS) and digital droplet PCR assays. This interview took place at the 5th How to Diagnose and Treat: Acute Leukemias meeting of the European School of Hematology (ESH AL) in Mandelieu-La Napoule, France.
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Transcript
I think the NGS technique is highly sensitive, and so if we can expand that and validate it in T-ALL, that would be highly useful because that makes up in the young adult population up to 30% of our patients. And so I think that that will be important. I don’t know of additional new techniques. There are these digital droplet PCR assays that can be implemented potentially for very high-risk subsets like the KMT2A rearranged ALL...
I think the NGS technique is highly sensitive, and so if we can expand that and validate it in T-ALL, that would be highly useful because that makes up in the young adult population up to 30% of our patients. And so I think that that will be important. I don’t know of additional new techniques. There are these digital droplet PCR assays that can be implemented potentially for very high-risk subsets like the KMT2A rearranged ALL. I know there are a number of groups working on that sort of approach that have not yet been completely validated, although validation studies are ongoing for that. So I think some of the digital droplet PCR for specific fusions will be useful, and then NGS as a broad stroke for most patients with ALL. At this moment, high sensitivity flow cytometry for MRD, I would say, is still the standard of care although many patients with T-ALL probably have robust markers that can be tracked but it’s just not quite as it’s not a hundred percent validated yet and it’s not yet FDA approved in the United States for monitoring MRD.
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