B-lineage acute lymphoblastic leukemia (ALL) that shows persistent or recurrent minimal residual disease (MRD) above 0.1% — whether detected in first or later remission — represents a situation in which a change of therapy is recommended.
Patients with B-lineage ALL in whom MRD remains above 0.1% — or returns to that level — face a recognised risk of relapse. Current evidence supports changing the therapeutic approach when this level of persistent or recurrent MRD is confirmed. This applies to patients identified in first remission as well as in later remissions.
The approach in this scenario involves a targeted agent — the only compound evaluated in a pivotal trial specifically for MRD-positive B-lineage ALL — used with the goal of achieving complete molecular remission. Treatment is generally intended as a bridge toward further consolidation.
Full regimen details, sequencing, and eligibility criteria available via the protocol →Achievement of complete molecular remission after the first cycle of therapy.
DOI: 10.1182/blood.2023023568