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  • Letter to the Editor
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Reply to Ross et al.

Leukemia volume 23, page 820 (2009)Cite this article

We thank Ross et al.1 for their additional comments on the definition of sensitivity with regard to minimal residual disease (MRD) in leukemia. Ross et al.1 highlight two important issues that have to be addressed when estimating the lower limit of detection of MRD by a PCR assay: (1) the amount of DNA or RNA in each assay, and the number of replicates performed; and (2) the quality of the individual sample analysed.

We fully agree with these comments and the calculations that are provided by Ross et al. However, we would still challenge the statement that the standardized reporting of the estimated lower limit of detection of PCR assays for leukemia MRD is highly desirable. In clinical practice, we will always define a threshold of MRD that we use for therapeutic decisions, that is, if the MRD in a patient is above this threshold, we will perform a more intensive treatment than in another patient with an MRD below this threshold.2

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References

  1. Ross DM, Brandford S, Melo JV, Timothy PH . Reply to ‘What do we mean by sensitivity when we talk about detecting minimal residual disease?’ by Steinbach and Debatin. Leukemia (in press).

  2. Steinbach D, Debatin KM . What do we mean by sensitivity when we talk about detecting minimal residual disease? Leukemia 2008; 22: 1638–1639.

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  3. Butturini A, Klein J, Gale RP . Modeling minimal residual disease (MRD)-testing. Leuk Res 2003; 27: 293–300.

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Authors and Affiliations

  1. Department of Pediatric Oncology, University Hospital Ulm, Ulm, Germany

    D Steinbach & K-M Debatin

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  1. D Steinbach
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  2. K-M Debatin
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Correspondence to D Steinbach.

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Steinbach, D., Debatin, KM. Reply to Ross et al.. Leukemia 23, 820 (2009). https://doi.org/10.1038/leu.2008.331

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