MRD: ASH 2022 the MRD2STOP Guide
By Ben Derman, MD
MRD (minimal residual disease) stands for measurable, or some say minimal residual disease. It means the lack of detectable disease on the order of 10 to the minus sixth meaning 1 in a million cells that we can look at. When you have MRD negativity at that level, that really carries the most superior prognosis. In our study, we took patients who were in either in a sustained complete response over 2 years, or who had MRD (minimal residual disease) negativity with, at least a year prior, who also had a negative PET scan. That includes a PET scan to look for extra medullary disease, bone marrow aspirations and next generation sequencing using the clonoSEQ assays.
And we did some other exploratory analyses in the peripheral blood as well as the bone marrow. The majority, 95% of these patients were still in their first line of therapy. When you look at the number of high-risk patients that we had on the study this comprised about 40% of. And the median time that patients were on some kind of additional therapy after a stem cell transplant or after just induction, if they did not receive a transplant. 5 out of 38 patients had something detectable, but only 2 of those 5 patients actually had disease progression.
Only 1 of the patients who was negative by all testing that we did, including 10 of the minus seventh, had converted to MRD (minimal residual disease) positivity at a later point. So that's, I think the real key thing here is that patients who are 10 to minus seventh positive, seem to be at a higher risk of developing disease progression or MRD resurgence.
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