Greenberg Megan R, Lucido Thomas, Singh Kritika, Rhodes Joanna M
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Rutgers Cancer Institute, New Brunswick, NJ 08901, USA.
Cancers (Basel). 2025 May 20;17(10):1708. doi: 10.3390/cancers17101708.
The treatment of chronic lymphocytic leukemia (CLL) has advanced considerably in recent years. Bruton's tyrosine kinase inhibitors (BTKis) and B-cell lymphoma 2 inhibitors (BCL2is) such as venetoclax have largely supplanted chemoimmunotherapy for both frontline and relapsed CLL. With the introduction of additional innovative agents and regimens, the clinical role of measurable residual disease (MRD) has become complicated. In this article, we will review the existing literature on MRD and its utility in the management of CLL. We will review the definitions of MRD, review MRD detection methods, and discuss the use of MRD in the current CLL treatment landscape. In doing so, we will clarify the present and conceivable future roles of MRD for the treatment of CLL. MRD is a powerful tool to assess response to CLL therapies, and can be prognostic with certain treatment regimens, such as fixed-duration venetoclax-based treatment. While we do not recommend MRD testing in routine clinical practice, we believe it has an important role in assessing treatment response and will be utilized routinely in the future. Further studies to incorporate MRD into treatment strategies for CLL are ongoing and will help to inform how we utilize it in clinical practice.
近年来，慢性淋巴细胞白血病（CLL）的治疗取得了长足进展。布鲁顿酪氨酸激酶抑制剂（BTKis）和维奈克拉等B细胞淋巴瘤2抑制剂（BCL2is）在很大程度上已取代了一线和复发CLL的化学免疫疗法。随着更多创新药物和治疗方案的引入，可测量残留病（MRD）的临床作用变得复杂起来。在本文中，我们将回顾关于MRD及其在CLL管理中的应用的现有文献。我们将回顾MRD的定义，回顾MRD检测方法，并讨论MRD在当前CLL治疗格局中的应用。通过这样做，我们将阐明MRD在CLL治疗中的当前和可预见的未来作用。MRD是评估CLL治疗反应的有力工具，并且对于某些治疗方案，如基于固定疗程维奈克拉的治疗，具有预后价值。虽然我们不建议在常规临床实践中进行MRD检测，但我们认为它在评估治疗反应方面具有重要作用，并且未来将被常规使用。将MRD纳入CLL治疗策略的进一步研究正在进行中，这将有助于指导我们在临床实践中如何使用它。
