Dr. Litzow on MRD Assessment in ALL

Mark R. Litzow, MD, chair, ECOG-ACRIN Leukemia Committee, professor of medicine, Division of Hematology, Mayo Clinic, discusses ways of conducting minimal residual disease (MRD) assessments in patients with acute lymphoblastic leukemia (ALL).

Litzow says there are two accepted approaches for MRD assessment: flow cytometry or polymerase chain reaction. Flow cytometry looks for abberant antigen expression of the lymphoblast while polymerase chain reaction looks at T cell receptor gene rearrangements for T cell ALL and hemoglobin gene rearrangements for B cell ALL. The polymerase chain reaction technique is more labor intensive because primers have to be developed for each patient, Litzow says. While the polymerase chain reaction method is slightly more sensitive than flow cytometry, flow cytometry is still an acceptable way to assess MRD.

Currently, next generation sequencing is being tested as a method for assessing MRD. Litzow feels that this will likely become standard practice within the next few years. ​