The Evolving Use of Minimal Residual Disease (MRD) Assessment in Chronic Lymphocytic Leukemia: Q&A

摘要

H&O How are you incorporating MRD assessment into clinical practice? Anthony R. Mato, MD, MSCE There are 2 situations where I am using MRD to make clinical decisions. The first is in the small minority of patients with CLL who are IGHV-mutated without a TP53 mutation or deletion 17p, who are treated with FCR. In this population, I assess MRD by flow cytometry in the bone marrow after the first 3 cycles of therapy. This strategy is based on a retrospective unplanned analysis of the FCR300 trial that suggested these patients may have similar outcomes regardless of whether they stop FCR early or complete 6 cycles. It should be noted, however, that this endpoint was not included in the original design of the trial. There were some patients who underwent MRD assessment after 3 cycles and then had to discontinue therapy. It turns out that these patients did well.