Using Minimal Residual Disease Detection to Monitor Outcomes in CLL Treatment
Posted: Friday, October 25, 2019
A recent review article highlighted the standardized and technical approaches to detecting minimal residual disease in chronic lymphocytic leukemia (CLL) as well as the impact of minimal residual disease monitoring on chemoimmunotherapy and other treatments. Ilaria Del Giudice, MD, of Sapienza University of Rome, and colleagues published their findings in Frontiers in Oncology.
The assessment of minimal residual disease in CLL is based upon real-time quantitative polymerase chain reaction (PCR) with allele-specific oligonucleotide primers of immunoglobin heavy chain genes. Other ways of monitoring minimal residual disease are being developed, such as droplet digital PCR, next-generation sequencing-based approaches, and plasma cell-free DNA to measure the extent of residual disease. Quantifying minimal residual disease serves as a prognostic marker of progression-free and overall survival for patients who have received chemoimmunotherapy or allogeneic transplantation.
The authors of the study pointed out that as the types of drugs being used are changing, the way the disease is monitored may change as well. For example, the use of drugs such as ibrutinib has led to increased progression-free and overall survival in both patients with relapsed or refractory disease and treatment-naive leukemia. In addition, chemotherapy-free combinations of drugs such as venetoclax and rituximab or venetoclax and obinutuzumab may create undetectable minimal residual disease in the bone marrow. Therefore, treatment based on minimal residual disease and disease eradication is becoming more realistic, according to the authors. Minimal residual disease–negative complete remission may prove to be useful as a goal in the potential cure of CLL.
Disclosure: The study authors reported no conflicts of interest.