Background:The treatment of chronic lymphocytic leukemia (CLL) has advanced considerably in recent years. Bruton’s tyrosine kinase inhibitors (BTKis) and B-cell lymphoma 2 inhibitors (BCL2is) such as venetoclax have largely supplanted chemoimmunotherapy for both frontline and relapsed CLL. With the introduction of additional innovative agents and regimens, the clinical role of measurable residual disease (MRD) has become complicated.Methods:In this article, we will review the existing literature on MRD and its utility in the management of CLL. We will review the definitions of MRD, review MRD detection methods, and discuss the use of MRD in the current CLL treatment landscape. In doing so, we will clarify the present and conceivable future roles of MRD for the treatment of CLL.Conclusions:MRD is a powerful tool to assess response to CLL therapies, and can be prognostic with certain treatment regimens, such as fixed-duration venetoclax-based treatment. While we do not recommend MRD testing in routine clinical practice, we believe it has an important role in assessing treatment response and will be utilized routinely in the future. Further studies to incorporate MRD into treatment strategies for CLL are ongoing and will help to inform how we utilize it in clinical practice.
背景：近年来，慢性淋巴细胞白血病（CLL）的治疗取得了显著进展。布鲁顿酪氨酸激酶抑制剂（BTKis）和B细胞淋巴瘤2抑制剂（BCL2is，如维奈托克）已在初治和复发CLL的治疗中基本取代了化学免疫疗法。随着更多创新药物和治疗方案的出现，可测量残留病（MRD）的临床作用变得复杂化。 方法：本文综述了关于MRD及其在CLL管理中应用的现有文献。我们将回顾MRD的定义，总结MRD检测方法，并探讨MRD在当前CLL治疗格局中的应用。通过这一梳理，旨在阐明MRD在CLL治疗中当前及未来可能发挥的作用。 结论：MRD是评估CLL治疗反应的有效工具，在某些治疗方案（如固定疗程的维奈托克为基础的治疗）中具有预后价值。虽然目前不建议在常规临床实践中进行MRD检测，但我们认为其在评估治疗反应方面具有重要作用，未来将得到常规应用。目前正在开展进一步研究以将MRD纳入CLL治疗策略，这将为临床实践中的应用提供指导。
The Impact of Minimal Residual Disease Measurement in the Management of Chronic Lymphocytic Leukemia
肿瘤(癌症)患者之家