Measurable residual disease-guided therapy in acute myeloid leukaemia: Practical insights

Abstract

Measurable residual disease (MRD) is a prognostic marker in patients with acute myeloid leukaemia (AML). This review examines the role of MRD assessment in guiding treatment strategies. We evaluate key questions, such as the prognostic power of MRD in specific genetic subgroups of AML, the optimal pre-emptive approach for MRD persistence or recurrence, the effect of MRD on allogeneic stem cell transplantation decisions and MRD-guided maintenance considerations. The absence of randomized trials comparing MRD-guided treatment strategies precludes definitive statements. However, by critically evaluating recent studies and emerging trends, we highlight the evolving role of MRD as a decision-making tool in AML, identify key gaps in evidence and suggest directions for future research to optimize personalized treatment approaches.