MRD-negative complete remission
MRD-negative complete remission means not just no leukaemia visible under the microscope, but none detectable with tests a thousand times more sensitive. It is the goal of modern leukaemia treatment.
Complete remission with undetectable measurable residual disease by flow (10^-4) or molecular methods (10^-5 to 10^-6). Prognostic across AML, ALL, CLL, and myeloma; accepted as a regulatory endpoint in ALL (blinatumomab MRD+ label) and, since FDA ODAC 2024, as an accelerated-approval endpoint in myeloma. Drives transplant decisions (AML), blinatumomab consolidation (ALL), and duration debates (CLL).
E1910 changed the standard of care for adult B-ALL: immunotherapy is now part of front-line consolidation even for patients with no detectable leukaemia, because MRD-negative by flow cytometry does not mean cured. It also demonstrated that a T-cell engager can improve overall survival in a curative setting. Chemotherapy-light or chemotherapy-free regimens built on blinatumomab and inotuzumab are the next step.
Revumenib proved that a transcriptional dependency, rather than a kinase, can be drugged in leukaemia, opening treatment for two genetic subgroups that together cover roughly a third of AML plus most infant ALL. It is now approved and is being combined with venetoclax-azacitidine and intensive chemotherapy in front-line trials. Single-agent remissions are often short without transplant.
VIALE-A turned a palliative regimen into one that produces remission in two-thirds of older AML patients and is now the reference treatment for anyone not fit for intensive chemotherapy. It shifted the field towards lower-intensity targeted combinations and opened the door to adding FLT3, IDH and menin inhibitors to the backbone. Cure remains uncommon and most patients relapse within two years.
This paper is the proof-of-concept for a living drug: a single infusion of a patient's own engineered T cells could eradicate leukaemia that had survived chemotherapy, transplant and antibody therapy. It defined cytokine release syndrome and its antidote, tocilizumab, and revealed antigen-loss relapse. It led directly to the first approved gene-modified cell therapy three years later.
Pages like this
not linked directly; found by shared links- CompanyAdaptive Biotechnologies
Shares NGS-based MRD (clonoSEQ and molecular MRD), Dormant cells and minimal residual disease, Chronic lymphocytic leukaemia, MRD / molecular residual disease testing.
- PairingMenin inhibitor + venetoclax + azacitidine
Shares VIALE-A: venetoclax plus azacitidine for older adults with acute myeloid leukaemia who cannot have intensive chemotherapy, NPM1 mutation, AUGMENT-101: revumenib, the first menin inhibitor, in relapsed leukaemias driven by KMT2A rearrangement or NPM1 mutation, Acute myeloid leukaemia.
- TermELN 2022 risk classification
Shares MRD-guided transplant decisions in intermediate-risk AML, NPM1 mutation, Allogeneic stem cell transplantation, Acute myeloid leukaemia.
- ProductZiftomenib
Shares myeloMATCH, NPM1 mutation, AUGMENT-101: revumenib, the first menin inhibitor, in relapsed leukaemias driven by KMT2A rearrangement or NPM1 mutation, Acute lymphoblastic leukaemia.
- Key paperCLL14: one year of venetoclax plus obinutuzumab instead of chemo-immunotherapy in older, less fit CLL patients
Shares CLL14, CLL13 / GAIA, Dormant cells and minimal residual disease, Minimal / molecular residual disease (MRD).
- InstitutionGIMEMA
Shares Minimal / molecular residual disease (MRD), Chronic lymphocytic leukaemia, MRD / molecular residual disease testing, Multiple myeloma.
- ProductVenetoclax
Shares CAPTIVATE, MRD-guided treatment duration in CLL, CLL14, myeloMATCH.
- TrialAUGMENT-101
Shares NPM1 mutation, AUGMENT-101: revumenib, the first menin inhibitor, in relapsed leukaemias driven by KMT2A rearrangement or NPM1 mutation, Acute lymphoblastic leukaemia, Acute myeloid leukaemia.