Consolidation Therapy To Eliminate Minimal Residual Disease

A CR by current criteria (see Chapter 25) goes beyond the former definition of the absence of detectable disease by histologic review of a bone marrow sample. Modern flow cytometric techniques are capable of detecting CLL clones well below our ability to see them histologically. The presence of residual disease that eludes our ability to detect it histologically is known as mininal residual disease (MRD). Nearly every study that has explored the clinical importance of MRD has concluded that patients with MRD following a course of cytotoxic treatment have a worse prognosis than do those who have no detectable MRD.8 9 Other studies suggest that treatment of MRD improves survival in those who have it successfully eradicated.10-12 However, it is not proven that the elimination of MRD in those patients who have it will improve their otherwise poor survival. The treatment of MRD remains an area of active investigation, but cannot yet be considered standard therapy.

0 0

Post a comment