Relapsed disease and aspects of undetectable MRD and treatment discontinuation

Hematology Am Soc Hematol Educ Program. 2019 Dec 6;2019(1):482-489. doi: 10.1182/hematology.2019000070.

Abstract

Continuous treatment vs fixed duration of monotherapies and combinations of targeted agents are treatment options in relapsed chronic lymphocytic leukemia. The optimal choice of relapse treatment is dependent on the prior frontline therapy, duration of remission after frontline, genetic markers, and patients' condition, including age and comorbidities. Combination therapies may result in deep responses with undetectable minimal residual disease (uMRD). Although uMRD is an excellent predictive marker for disease progression, it is rarely used in clinical practice and needs additional evaluation in clinical trials before discontinuation of therapy should be guided according to uMRD.

Publication types

  • Case Reports

MeSH terms

  • Adenine / analogs & derivatives
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Biomarkers, Tumor / blood*
  • Bridged Bicyclo Compounds, Heterocyclic / administration & dosage
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / blood
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell* / pathology
  • Neoplasm, Residual
  • Piperidines
  • Pyrazoles / administration & dosage
  • Pyrimidines / administration & dosage
  • Recurrence
  • Rituximab / administration & dosage
  • Sulfonamides / administration & dosage

Substances

  • Biomarkers, Tumor
  • Bridged Bicyclo Compounds, Heterocyclic
  • Piperidines
  • Pyrazoles
  • Pyrimidines
  • Sulfonamides
  • ibrutinib
  • Rituximab
  • Adenine
  • venetoclax