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Treatment and the treatment process

MRD (measurable residual disease)

MRD measures the tiny number of leukaemia cells left in remission that cannot be seen under the microscope.

Last updated: ~1 min read
One in a million — MRD (measurable residual disease)
Figure 1.One in a million — MRD (measurable residual disease)

01Short answer

MRD tests can find one cell in 10,000 or even one in 1,000,000. Flow cytometry, PCR or next-generation sequencing are used. An MRD-negative result usually means a better outlook; an MRD-positive result can influence decisions about stronger treatment, a transplant or a targeted medicine. It is widely used in ALL, AML and CML.

02Simple explanation

Topic. MRD (measurable residual disease).

Ask. Your team will explain your own situation.

Write down. Your questions.

Overview. The article “Measurable residual disease (MRD)”.

03Scientific explanation

Sensitivity: the smallest share of cells a test can detect.

Trend: change over time matters more than a single result.

04What happens in the body?

MRD (measurable residual disease)

MRD tests can find one cell in 10,000 or even one in 1,000,000. Flow cytometry, PCR or next-generation sequencing are used. An MRD-negative result usually means a better outlook; an MRD-positive result can influence decisions about stronger treatment, a transplant or a targeted medicine. It is widely used in ALL, AML and CML.

In more detail

Sensitivity: the smallest share of cells a test can detect. Trend: change over time matters more than a single result.

A laser beam — MRD (measurable residual disease)
Figure 2.A laser beam — MRD (measurable residual disease)

The overview

This article goes deep into one subject. For the bigger picture, see “Measurable residual disease (MRD)”.

An MRD line — MRD (measurable residual disease)
Figure 3.An MRD line — MRD (measurable residual disease)

05MRD (measurable residual disease): the steps

Four steps.

Sample — Marrow or blood.1SampleMarrow or blood.
Test — A sensitive method.2TestA sensitive method.
Result — Positive or negative.3ResultPositive or negative.
Decision — The plan.4DecisionThe plan.

06Methods

MethodWhat it findsWhere
Flow cytometrySurface markersALL, AML
PCRA specific geneCML, NPM1 AML
SequencingMutationsAt some centres

07Key terms

MRD-negative
The test found no cells.
Flow cytometry
A method that counts cells with a light beam.

08Key points

  • Everyone’s plan is individual.
  • Write down and bring your questions.
  • Report new symptoms early.
  • Do not change medicines yourself.
  • For food, see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”.
  • Overview: “Measurable residual disease (MRD)”.

09Frequently asked questions

Is MRD-positive a relapse?

Not necessarily; it is a risk marker and the plan may change.

Is this the same for everyone?

No; the plan depends on the type of leukaemia and your situation.

Where is the overview?

In the article “Measurable residual disease (MRD)”.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Is MRD-positive a relapse?

  2. Is this the same for everyone?

  3. Where is the overview?

My questions

12Sources

  1. National Cancer Institute (NCI). Definition of minimal residual disease – NCI Dictionary
  2. MedlinePlus. Leukemia
  3. National Cancer Institute (NCI). Biomarker Testing / Precision Medicine
  4. ICUsteps. Guide to intensive care: returning home
  5. NICE. Rehabilitation after critical illness in adults (CG83)
  6. Acute Medicine & Surgery, 2019. Post-intensive care syndrome: its pathophysiology, prevention, and future directions
  7. NHS. Post-traumatic stress disorder (PTSD)
  8. MedlinePlus. Epilepsy
  9. MedlinePlus. Autoimmune Diseases
  10. MedlinePlus. Mouth Disorders
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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