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ACUTE LYMPHOBLASTIC LEUKEMIA

Quantifying measurable residual disease correctly

Leukemia volume 38, pages 221–222 (2024)Cite this article

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Determining the measurable residual disease (MRD) level in a patient with leukemia is used to decide on treatment. The MRD result is an estimate of the true level of MRD in the patient and indicates whether the latter is likely to fall above or below a consensus “cut-off” MRD level, which is used to decide between two treatments of different intensity. The cut-off level is based on evidence from clinical trials concerning the probabilities, consequences, and weightings of outcomes, including relapse, morbidity, mortality, and subsequent treatments. The principle underlying general agreement on the value of the cut-off is that decisions based on it will maximise the positive outcomes and minimise the negative outcomes for the patient population as a whole.

The conventional MRD test-result is the statistical best or most likely estimate of the true level of MRD in the patient being tested. It is, however, only one member of a probability distribution of estimates which results from the various types of variation which can influence the test.

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References

  1. Feng Y, Qi S, Liu X, Zhang L, Hu Y, Shen Q, et al. Have we been qualifying measurable residual disease correctly? Leukemia. 2023. https://doi.org/10.1038/s41375-023-02026-4.

  2. Latham S, Hughes E, Budgen B, Mechinaud F, Crock C, Ekert H, et al. Sources of error in measurement of minimal residual disease in childhood acute lymphoblastic leukemia. PLoS One. 2017;12:e0185556.

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  1. Department of Haematology and Genetic Pathology, Flinders University, Adelaide, Australia

    Alexander A. Morley

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  1. Alexander A. Morley
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This letter does not contain original research, has not been published elsewhere, has not been submitted for publication elsewhere and is exclusively the contribution of the author.

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Correspondence to Alexander A. Morley.

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Morley, A.A. Quantifying measurable residual disease correctly. Leukemia 38, 221–222 (2024). https://doi.org/10.1038/s41375-023-02106-5

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