Why Measurable Residual Disease (MRD) Is An Important Test in Acute Myeloid Leukemia
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/ Published Mar 21, 2022

Why Measurable Residual Disease (MRD) Is An Important Test in Acute Myeloid Leukemia

Medically Reviewed: Dr. Adrienne Phillips Written by Dr. Jerry Lee
University of California, San Francisco (UCSF)

What Is MRD?

  • Measurable residual disease (also known as minimal residual disease), or MRD, is an important concept in the treatment of blood cancers.
  • Since blood cancers arise from the bone marrow (where all the blood-forming cells in your body originate), doctors need to sample your bone marrow from time to time to see what the state of your cancer is.
  • Reaching an MRD-negative status has good implications for prognosis and may affect the timing of your transplant (if planned). To assess for MRD, doctors use advanced techniques to test your bone marrow for residual cancer.
Measurable residual disease (also known as minimal residual disease), or MRD, is an important concept in the treatment of blood cancers such as acute myeloid leukemia. Unlike solid cancers, blood cancers do not usually form a mass in the body that can be tracked with imaging. Since blood cancers arise from the bone marrow (where all the blood-forming cells in your body originate), doctors need to sample your bone marrow from time to time to see what the state of your cancer is.

Like all cancers, leukemia cells will tend to "hide" in your body at low levels.

Read More
It’s important to remember:

  • Even if you reach a "complete remission," this does not mean you are "cancer-free."
  • Physicians do not like to use the words "cancer-free" or "cure" until at least five years after they cannot find acute myeloid leukemia in your body.
MRD is important in leukemia because getting patients to an MRD-negative state has good implications for prognosis and may affect the timing of your transplant (if planned).

To assess an acute myeloid leukemia patient for MRD:

  • Doctors use advanced techniques to test your bone marrow for residual cancer.
  • These sensitive tools can detect even one cancer cell in the few million cells that we sample.

Interpreting the results:

  • If doctors cannot find evidence of cancer using these tools, then you are "MRD-negative."
  • If you are MRD-positive, don't worry being MRD-positive does not mean you cannot be cured of your cancer. Your physician has various strategies to help you achieve an MRD-negative status if needed.

You should ask your physician if MRD-testing is appropriate for you. Since this is a newer tool, some oncologists may not be aware of it or have not used it in their decision-making yet. Therefore, we recommend seeking a second opinion from a large academic hospital that treats a lot of leukemia patients for guidance. Due to the availability of virtual visits now, a leukemia specialist at an academic hospital can easily see you and provide guidance directly to your local oncologist.

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Dr. Jerry Lee is a SurvivorNet oncology fellow and hematology/oncology fellow at the University of California, San Francisco (UCSF). Read More

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