Evaluating Ways of Measuring MRD in Hematologic Malignancies

Jerald P. Radich, MD, member, Clinical Research Division, Kurt Enslein Endowed Chair, Fred Hutchinson Cancer Research Center, and professor, University of Washington School of Medicine, discusses how minimal residual disease (MRD) is measured in hematologic malignancies.

In general, MRD can be measured with flow cytometry, which is a technique that measures aberrant antigen presentation on the cells. The sensitivity, however, with this technique is usually between 1 leukemia cell in 1,000 to 1 in, maybe, 104, Radich says.

Another approach is to use polymerase chain reaction (PCR)–based detection, which looks at either translocations or point mutations, Radich says. Next-generation sequencing is another approach for using a more wholesome approach at both the translocations and point mutations in 1 assay, although this approach sugars a little bit from sensitivity and cost issues.

New methods such as single-cell genomics are now underway to understand the complexity of clonal evolution and how a Darwinian selection paves the way for MRD in relapsed patients.

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