Minimal Residual Disease and Childhood Leukemia: Standard of Care Recommendations From the Pediatric Oncology Group of Ontario MRD Working Group

Uma H Athale; Paul J Gibson; Nicole M Bradley; David M Malkin; Johann Hitzler; POGO MRD Working Group

doi:10.1002/pbc.25939

Minimal Residual Disease and Childhood Leukemia: Standard of Care Recommendations From the Pediatric Oncology Group of Ontario MRD Working Group

Pediatr Blood Cancer. 2016 Jun;63(6):973-82. doi: 10.1002/pbc.25939. Epub 2016 Feb 23.

Authors

Uma H Athale^{1

2}, Paul J Gibson^{3

4}, Nicole M Bradley⁵, David M Malkin^{5

6

7

8}, Johann Hitzler^{6

7}; POGO MRD Working Group

Affiliations

¹ Division of Hematology/Oncology, Hamilton Health Sciences, McMaster Children's Hospital, Hamilton, Ontario, Canada.
² Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
³ Division of Hematology/Oncology, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada.
⁴ Department of Pediatrics, University of Western Ontario, London, Ontario, Canada.
⁵ Pediatric Oncology Group of Ontario (POGO), Toronto, Ontario, Canada.
⁶ Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁷ Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
⁸ Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.

PMID: 26914030
DOI: 10.1002/pbc.25939

Abstract

Minimal residual disease (MRD) is an independent predictor of relapse risk in children with leukemia and is widely used for risk-adapted treatment. This article summarizes current evidence supporting the use of MRD, including clinical significance, current international clinical practice, impact statement, and recommended indications. The proposed MRD recommendations have been endorsed by the MRD Working Group of the Pediatric Oncology Group of Ontario and provide the foundation for a strategy that aims at equitable access to MRD evaluation for children with leukemia.

Keywords: acute lymphoblastic leukemia; acute myeloid leukemia; hematopoietic stem cell transplantation; leukemia; leukemic relapse; minimal residual disease; pediatric; prognostication; risk stratification.

Publication types

Practice Guideline
Research Support, Non-U.S. Gov't
Review

MeSH terms

Child
Humans
Leukemia / pathology*
Leukemia / therapy
Medical Oncology / standards*
Neoplasm, Residual / diagnosis*
Neoplasm, Residual / therapy
Pediatrics / standards*
Standard of Care