Minimal residual disease in chronic lymphocytic leukemia: A consensus paper that presents the clinical impact of the presently available laboratory approaches

Abstract

Chronic lymphocytic leukemia (CLL) is a malignancy defined by the accumulation of mature lymphocytes in the lymphoid tissues, bone marrow, and blood. Therapy for CLL is guided according to the Rai and Binet staging systems. Nevertheless, state-of-the-art protocols in disease monitoring, diagnostics, and prognostics for CLL are based on the assessment of minimal residual disease (MRD). MRD is internationally considered to be the level of disease that can be detected by sensitive techniques and represents incomplete treatment and a probability of disease relapse. MRD detection has been continuously improved by the quick development of both flow cytometry and molecular biology technology, as well as by next-generation sequencing. Considering that MRD detection is moving more and more from research to clinical practice, where it can be an independent prognostic marker, in this paper, we present the methodologies by which MRD is evaluated, from translational research to clinical practice.

Keywords:

• Chronic lymphocytic leukemia
• minimal residual disease
• clinical relevance

Acknowledgements

Ciprian Tomuleasa, Cristina Selicean, and Sonia Cismas contributed equally to the current paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Ciprian Tomuleasa received funding from the Romanian Research Ministry, contracts [PN-II-RU-TE-2014-4-1783] (awarded to Young Research Teams) and [CNFIS-FDI-2017–1350] (awarded to Institutional development funds), as well as from an international collaboration grant between Romania and PR China, contract [57 BM/2016].