During our interview at the EHA (European Hematology Association) Congress from Copenhagen in June 2016, Dr. Stephan Stilgenbauer of the University of Ulm, Germany discusses the role of MRD (minimal residual disease) negativity in chronic lymphocytic leukemia (CLL).
Determining MRD after treatment for CLL requires the use of sophisticated techniques to detect residual CLL cells that might be otherwise undetectable by conventional means such as imaging and microscopy.
Flow cytometry looks for the immunologic fingerprints of the CLL cells and PCR (polymerase chain reaction) looks for the molecular signature of CLL. In theory, flow cytometry can detect one CLL cell in 10,000 cells and PCR maybe as few as one in 100,000 cells.
Take Away Points
- Achieving MRD negativity in a low-risk group of patients by using treatment with FCR, a common form of chemo-immunotherapy, can achieve very long remissions and maybe even cures.
- MRD may be much less important with ibrutinib and idelalisib.
- The early data suggests that those who achieve MRD negativity with venetoclax have more prolonged remissions compared to those who achieve it through treatment with other agents.
Please enjoy our interview from EHA 2016.
Brian Koffman, MD 10/20/16