MRD Testing in Pediatric and Adult ALL: Do Barriers Still Exist?
Monitoring minimal residual disease (MRD) is recommended for measuring treatment response and predicting relapse in patients with acute lymphoblastic leukemia (ALL). Investigators for an Amgen-sponsored study surveyed US hematologists/oncologists who treat ALL patients about their use of MRD testing. Respondents included 150 physicians who mainly treat adult patients (67% in community settings and 33% in academic settings) and 30 physicians who mostly treat pediatric patients (33% in community settings and 67% in community settings). Overall, 93% of pediatric treaters and 73% of adult treaters said they tested MRD in patients at least once. Only half of adult treaters followed a standard pathway for MRD testing compared with 93% of pediatric treaters. Community-based adult treaters were least likely to conduct MRD testing. Both cohorts cited cost and insurance hurdles as common barriers to more frequent MRD testing.
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Kim C, Delaney K, McNamara M, Chia V, Romanov V. Cross-sectional physician survey on the use of minimal residual disease testing in the management of pediatric and adult patients with acute lymphoblastic leukemia. Hematology. 2018;Aug 21:1-9. doi: 10.1080/10245332.2018.1510068.