Jerald P. Radich, MD, member, Clinical Research Division, Kurt Enslein Endowed Chair, Fred Hutchinson Cancer Research Center, and professor, University of Washington School of Medicine, discusses the impact of minimal residual disease (MRD) in patients with acute versus chronic leukemias.

Any level of MRD positivity is associated with bad outcomes in acute leukemias, says Radich. If patients with acute lymphoblastic leukemia or acute myeloid leukemia are MRD positive at the end of induction or consolidation therapy, their risk of relapse increases 3- to 5-fold compared with patients who achieve MRD negativity, adds Radich.

MRD does not appear to impact those with chronic leukemias as intensely. In fact, patients with chronic lymphocytic leukemia, multiple myeloma, or chronic myeloid leukemia can have low levels of MRD and not experience relapse, according to Radich. If levels of disease are low enough, patients can still have presence of their disease by MRD without necessarily being at high risk of relapse, concludes Radich.