Emerging technologies for minimal residual disease detection in hematologic malignancies

Area of Science:

• Hematology
• Oncology
• Biomarker Detection

Background:

• Minimal residual disease (MRD) detection is crucial for prognosis, therapy guidance, and relapse monitoring in hematologic malignancies.
• Current standard assays (flow cytometry, PCR, NGS) use invasive bone marrow aspirates, limiting assessment frequency and site evaluation.
• These limitations can lead to missed spatially heterogeneous or extramedullary disease.

Purpose of the Study:

• To review the principles and clinical readiness of conventional and emerging MRD assays.
• To discuss how these approaches can enhance disease monitoring and therapeutic decision-making in hematologic cancers.

Main Methods:

• Review of current gold-standard MRD detection methods (flow cytometry, PCR, NGS) using bone marrow aspirates.
• Discussion of emerging MRD surveillance approaches, including plasma-based assays and imaging techniques.
• Analysis of the clinical utility and readiness of both conventional and novel MRD detection strategies.

Main Results:

• Conventional MRD assays are highly sensitive but invasive, restricting monitoring frequency and scope.
• Emerging plasma-based and imaging assays offer potential for broader, more frequent, and less invasive disease surveillance.
• These novel approaches may overcome limitations of bone marrow sampling for comprehensive MRD evaluation.

Conclusions:

• Advances in MRD detection are essential for improving patient outcomes in hematologic malignancies.
• Emerging non-invasive techniques show promise for more effective and frequent monitoring of minimal residual disease.
• Integrating conventional and novel MRD assays can optimize treatment strategies and relapse prediction.