MRD-directed and risk-adapted individualized stratified treatment of AML

Yijing Zhao; Hanfei Guo; Yingjun Chang

doi:10.21147/j.issn.1000-9604.2023.05.04

MRD-directed and risk-adapted individualized stratified treatment of AML

Chin J Cancer Res. 2023 Oct 30;35(5):451-469. doi: 10.21147/j.issn.1000-9604.2023.05.04.

Authors

Yijing Zhao¹, Hanfei Guo^{2

3}, Yingjun Chang¹

Affiliations

¹ Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
² Stanford University Medical School, VA Palo Alto Health Care System, Palo Alto 94304, USA.
³ the First Hospital of Jilin University, Cancer Center, Changchun 133021, China.

PMID: 37969959
PMCID: PMC10643342
DOI: 10.21147/j.issn.1000-9604.2023.05.04

Abstract

Measurable residual disease (MRD) has been widely recognized as a biomarker for deeply evaluating complete remission (CR), predicting relapse, guiding pre-emptive interventions, and serving as an endpoint surrogate for drug testing. However, despite the emergence of new technologies, there remains a lack of comprehensive understanding regarding the proper techniques, sample materials, and optimal time points for MRD assessment. In this review, we summarized the MRD methods, sample sources, and evaluation frequency according to the risk category of the European Leukemia Net (ELN) 2022. Additionally, we emphasize the importance of properly utilizing and combining these technologies. We have also refined the flowchart outlining each time point for pre-emptive interventions and intervention paths. The evaluation of MRD in acute myeloid leukemia (AML) is sophisticated, clinically applicable, and technology-dependent, and necessitates standardized approaches and further research.

Keywords: Measurable residual disease; acute myeloid leukemia; risk stratification.