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But it may cause serious side effects that can be severe or life-threatening.
In addition, Blinatumomab, a bispecific T-cell engager (BiTE) associated with improved survival in relapsed or refractory acute lymphoblastic leukaemia (ALL), is the only US FDA approved treatment of MRD. If there is still MRD after many rounds of chemotherapy, that is an indication that the patient may need to have a stem cell transplant, when otherwise it might not have been appropriate.
In a leukaemia patient, if there is MRD after the first cycle of chemotherapy treatment, it indicates that probably there is a need to give more treatment, either a different medication or a different course of treatment. Although by using these assays, it can be quantified whether a patient has MRD, the real difficulty lies in fixing it. It is also easier to complete in several hours than PCR and FCM, because the process is so automated. NGS is considered more accurate at detecting MRD and can lessen the chances of it going undetected. For instance, MRD in case of lymphoma is detected through FCM and PCR, while MRD testing in myeloma uses FCM, NGS and imaging tests. The most widely used tests for MRD detection are flow cytometry (FCM), polymerase chain reaction (PCR) and next-generation sequencing (NGS), depending on the type of cancer. Further challenges include the lack of a definitive assay for MRD with established clinical utility, and difficulty in selecting potential interventions due to limitations in understanding the biology of MRD. Use of prognostic molecular tools may be able to directly screen those patients that are most likely to harbour MRD, but the relationship between these predictors and MRD detection is yet undefined.
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