Clinical case: PAtient wilt ALL seeks consulation for transplant or not. What is the value of MRD diagnostic? How do we perform MRD diagnostic

Discussion: We discussed the challenges of MRD. The new nomenclature names MRD not minimal residula disease but measurable residual disease. Howerver there are a lot of emthodologies to measure MRD. We discussed the challenges of FACS, specific primer PCR and NGS. AT our Unit, FACS is of low sensitivity (about 1%) since we do not use Eyroflow multicolor FACS. IgPCR is perfomred at University of AThens (Prof Panayotidis), is sensitive but is has drawbacks, eg designing the primers, preferential amplification etc. Our Lab has a signed contract with karaiksakeio Foundation which performs NGS based evalaution of MRD in ALL (ISO approved).For molecular techiques, materila at the first diagnosis is needed. NGS based methodology is now evaluated in clinical studies and it seems that it may efficiently identify patients with hiogh risk of relapse, eg identify patients that will need a transplant. We await the final results (methodology, timing etc). We discussed a very nice review in Blood regarding the challenges if MRD diagnostic in ALL

Lecturer: Spyridonidis

Participants: all medical staff

For NGS based MRD diagnositic in ALL, please send 2 EDTA tubes in our Lab (at daignosis, and than for FU)