Role of Minimal Residual Disease Assessment in Hematological Cancers

Dear Colleagues,

Early identification of patients at high risk of relapse is a major goal of current translational research in oncohematology. Minimal residual disease (MRD) detection is increasingly employed in multiple different settings as additional tissue sources become useful targets for monitoring. Moreover, methods for MRD detection are rapidly evolving, thanks to substantial technical improvements of traditional approaches, such as real time polymerase chain reaction (PCR) and multiparameter flow cytometry and development of novel highly effective tools (digital droplet PCR and next generation sequencing). In the meantime, MRD diagnostics is applied to a number of novel clinical settings. In some entities, such as acute lymphoblastic leukemia, MRD detection by real time PCR using patient specific primers is already part of the routine clinical management of adult and pediatric patients. In other entities, such as follicular lymphoma, mantle cell lymphoma, chronic lymphocytic leukemia and multiple myeloma, MRD is a well-established prognostic tool and clinical trials employing MRD as a decision-making tool are currently ongoing. Finally in some entities, such as Hodgkin Lymphoma aggressive lymphoma and lymphoplasmacytic lymphoma, MRD diagnostics is highly promising but still in its infancy, In the present review, we shall discuss the 'state-of-the-art' of MRD evaluation in these neoplasms with the ultimate aim of providing critical take-home messages for clinicians working in the field. Moreover, we will outline the role of MRD detection in the design of future clinical trials.

Dr. Marco Ladetto
Gues Editor

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