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When Is It Appropriate for CLL Patients to Do an MRD Test?

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Published on March 13, 2019

Patient Power community member Maureen writes in, “Is it appropriate to do a minimal residual disease (MRD) test to see how deep the remission is?” During this Ask the Expert segment, chronic lymphocytic leukemia (CLL) expert Dr. Richard Furman, from Weill Cornell Medicine,responds by explaining when testing is recommended and how MRD test results impact the clinical management of CLL. Watch now to learn more.

This is a Patient Empowerment Network program produced by Patient Power. We thank AbbVie, Inc. and Pharmacyclics for their support.

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Transcript | When Is It Appropriate for CLL Patients to Do an MRD Test?

So MRD testing is easy, it's noninvasive, it's a peripheral blood test or a bone marrow biopsy, which I guess is only relatively noninvasive, and the information though is really not going to be of use.  So if you're taking a patient who's on ibrutinib and you're going to continue the ibrutinib (Imbruvica) knowing the MRD status won't change anything. Likewise, if you have a patient who's on venetoclax, who's going to get a year of venetoclax on trial and then stop, knowing the MRD status won't change anything as well.  So currently there's no real reason for doing MRD assessments in patients except for just the ability to know.  

Now, one day there's some modeling that suggests that the time it takes you to reach MRD negativity is half the time you need to be on a substance, an agent, before you can actually claim to have a deep enough remission that you won't relapse.  So we may one day say if you've been on ibrutinib for five years and became MRD negative, then 10 years of ibrutinib is enough and you can stop. But that's currently just theoretical and based on mathematical models.

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