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What does MRD in leukemia really mean?

Leukemia volume 28, page 1131 (2014)Cite this article

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The term minimal residual disease (MRD) is a leftover from an era when techniques to measure residual leukemia were rather insensitive by today’s standards. In acute myeloid leukemia, for example, the major definition of a complete remission in the 1970s was based on light microscopy and required the levels of blood cells to be normal and the bone marrow to contain fewer than 5% immature myeloid cells (blasts). However, there was no way to know whether these bone marrow cells were normal or leukemic. An important development was the advent of monoclonal antibodies and fluorescence-activated cell sorting that allowed the hematologist to make this distinction with reasonable accuracy. With this advance, some persons previously classified as having MRD could be shown to have many residual leukemia cells whereas others had none.

In the 1980s, complete response in chronic myeloid leukemia (CML) was defined as the absence of bone marrow cells with the Ph-chromosome, namely complete cytogenetic response. However, the sensitivity of this criterion depended on how many metaphases were studied. For example, if only 20 or 30 metaphases were examined there was a substantial likelihood of not detecting any leukemia in a sample where the Ph chromosome positive cells were 15% or lower.

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Acknowledgements

This work was supported by funding from the NIMR Biomedical Research Centre.

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  1. J M Goldman: Deceased.

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  1. Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK

    J M Goldman & R P Gale

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  1. J M Goldman
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  2. R P Gale
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Correspondence to R P Gale.

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Goldman, J., Gale, R. What does MRD in leukemia really mean?. Leukemia 28, 1131 (2014). https://doi.org/10.1038/leu.2013.318

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