Huynh V, Laetsch TW, Schore RJ, Gaynon P, O'Brien MM. Redefining treatment failure for pediatric acute leukemia in the era of minimal residual disease testing.
Pediatr Hematol Oncol 2017;
34:395-408. [PMID:
29190162 DOI:
10.1080/08880018.2017.1397073]
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Abstract
Technologies for the detection of minimal residual disease (MRD) in leukemia and our understanding of the prognostic implications of MRD at different phases of treatment have significantly improved over the past decade. As a result, definitions of treatment failure based on bone marrow morphology by light microscopy are becoming increasingly inadequate for clinical care and trial design. In addition, novel therapies that may have increased efficacy and decreased toxicity in the setting of MRD compared to overt disease are changing clinical practice and challenging investigators to redefine treatment failure, the role of disease surveillance in remission, and clinical trial eligibility in the era of MRD.
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