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Flow cytometry and molecular testing can see what microscopy cannot
Measurable residual disease (MRD) refers to cancer cells that remain after treatment but are below the limit of routine morphology. MRD is measured by multiparameter flow cytometry, quantitative PCR or next-generation sequencing, depending on the disease. It informs depth of response, relapse risk and treatment decisions in leukemia and myeloma.
Haematology & Haemato-Oncology
Authored and reviewed by Dr. Sachita Baniya (MBBS, FCPS (Clinical Haematology), NMC 20158). Evidence-based, no fabricated outcomes.
Measurable residual disease (MRD) refers to cancer cells that remain after treatment but are below the limit of routine morphology. MRD is measured by multiparameter flow cytometry, quantitative PCR or next-generation sequencing, depending on the disease. It informs depth of response, relapse risk and treatment decisions in leukemia and myeloma.
Reviewed by Dr. Sachita Baniya, MBBS, FCPS — Consultant Haemato-Oncologist & Clinical Hematologist (NMC 20158). For evaluation, contact the respective hospital or cancer centre — Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital Kathmandu, or Advanced Care Hospital.
The appropriate method depends on the disease and the validated assay. Flow cytometry detects abnormal immunophenotypes, while RQ-PCR and NGS detect specific gene fusions, mutations or clonal immunoglobulin sequences. Sensitivity differs by method, and results should be interpreted only with a validated threshold and a consistent assay over time.
In AML and ALL, MRD after induction and consolidation refines relapse risk and can prompt transplant consideration. In CML, BCR-ABL1 transcript levels guide TKI decisions. In myeloma, MRD complements protein response and is increasingly used in trials and selected practice. A negative result is not a guarantee of cure, and a positive result does not always require immediate treatment change.
Guidelines referenced:
European LeukemiaNet MRD recommendationsInternational Myeloma Working Group response criteriaNCCN Guidelines — Acute LeukemiasContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.