2021 Update Measurable Residual Disease in Acute Myeloid Leukemia: European LeukemiaNet Working Party Consensus Document

Michael Heuser, Sylvie D Freeman, Gert J Ossenkoppele, Francesco Buccisano, Christopher S Hourigan, Lok Lam Ngai, Jesse Marc Tettero, Costa Bachas, Constance Baer, Marie C Béné, Veit Buecklein, Anna Czyz, Barbara Denys, Richard Dillon, Michaela Feuring-Buske, Monica L Guzman, Torsten Haferlach, Lina Han, Julia K Herzig, Jeffrey L JorgensenWolfgang Kern, Marina Y Konopleva, Francis Lacombe, Marta Libura, Agata Majchrzak, Luca Maurillo, Yishai Ofran, Jan Philippé, Adriana Plesa, Claude Preudhomme, Farhad Ravandi, Christophe Roumier, Marion Subklewe, Felicitas Thol, Arjan A van de Loosdrecht, Bert A van der Reijden, Adriano Venditti, Agnieszka Wierzbowska, Peter J M Valk, Brent L Wood, Roland B Walter, Christian Thiede, Konstanze Döhner, Gail J Roboz, Jacqueline Cloos

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Abstract

Measurable residual disease (MRD) is an important biomarker in acute myeloid leukemia (AML) that is used for prognostic, predictive, monitoring, and efficacy-response assessments. The European LeukemiaNet (ELN) MRD working party evaluates standardization and harmonization of MRD in an ongoing manner and has updated the 2018 ELN MRD recommendations based on significant developments in the field. New and revised recommendations were established during in-person and online meetings, and a two-stage Delphi poll was conducted to optimize consensus. All recommendations are graded by levels of evidence and agreement. Major changes include technical specifications for next generation sequencing (NGS)-based MRD testing and integrative assessments of MRD irrespective of technology. Other topics include use of MRD as a prognostic and surrogate endpoint for drug testing; selection of the technique, material, and appropriate time points for MRD assessment; and clinical implications of MRD assessment. In addition to technical recommendations for flow- and molecular- MRD analysis, we provide MRD thresholds and define MRD response, and detail how MRD results should be reported and combined if several techniques are used. MRD assessment in AML is complex and clinically relevant, and standardized approaches to application, interpretation, technical conduct, and reporting are of critical importance.

Original languageEnglish
JournalBlood
DOIs
Publication statusE-pub ahead of print - 1 Nov 2021

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