International Cross-Age Consensus Guideline on Measurable Residual Disease Assessment in Acute Lymphoblastic Leukemia.

An international consensus guideline for measurable residual disease (MRD) assessment in acute lymphoblastic leukemia (ALL) reached agreement on 38 of 41 statements, standardizing methods and definitions.

• Why it matters: Global variability in MRD sampling, detection, thresholds, and interpretation limits cross-trial comparability and clinical standardization for risk stratification, response evaluation, and relapse detection.
• What they did: An international expert panel from major pediatric and adult study groups and reference laboratories used a structured current-practices survey followed by a multi-round Delphi process to set recommendations across pre-analytical, technical/nomenclature, and MRD-based remission/relapse domains.
• The result: Bone marrow was endorsed as the reference specimen and MRD was prioritized over cytomorphology when discordant, enabling more consistent MRD-guided decision-making while highlighting unresolved issues like anticoagulant choice for PCR-based MRD.

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