12.24.21

Peripheral Blood May Be “Adequate Alternative” to Bone Marrow for MRD Evaluation in Adults With ALL

Monitoring of MRD in peripheral blood (PB) may be an adequate alternative to bone marrow (BM) evaluations in adult patients with acute lymphoblastic leukemia (ALL) who are receiving cellular therapies. Researchers at Stanford University reported the finding in Blood Advances in August.

Sixty-nine patients were enrolled in the prospective observational study, of whom 62 underwent planned therapy (hematopoietic cell transplantation [HCT] or CAR T-cell therapy) and had a trackable clonal sequence for MRD measurement. MRD status was evaluated in 126 paired PB and BM samples using the clonoSEQ® assay.

The sensitivity and specificity of MRD detection in PB were 87% and 90%, respectively, relative to MRD in BM. “MRD became detectable in the PB in 100% of patients who subsequently relapsed following HCT, with median time from MRD+ to clinical relapse of 90 days, and in 85% of patients who relapsed following CAR T, with median time from MRD+ to clinical relapse of 60 days,” wrote Lori Muffly, MD, MS, and her colleagues.

“The use of PB as a source for MRD monitoring in ALL could increase access to MRD testing in patients with ALL, improve patient satisfaction by reducing the need for repeated invasive BM procedures, and facilitate serial monitoring in certain high-risk populations,” they added.

  • Muffly L, Sundaram V, Chen C, et al. Concordance of peripheral blood and bone marrow measurable residual disease in adult acute lymphoblastic leukemia. Blood Adv. 2021;5(16):3147-3151. doi:10.1182/bloodadvances.2021004234

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