When during ALL induction therapy are you checking for MRD?

It is generally advisable to measure MRD from a bone marrow aspirate at the end of the first course of therapy for ALL.

If a pediatric-inspired regimen such as CALGB 10403 is being used, undetectable MRD after Remission Induction (i.e., approximately Day 28) is associated with an excellent rate of disease-free survival, whereas persistent MRD can identify patients at higher risk of relapse. Fewer data are available from adult-inspired regimens, but both the groups at my center (Cassaday, et al. Am J Hematol 2018;93:546-52) and MD Anderson (Yilmaz, et al. Am J Hematol 2020;95;144-50) have shown that earlier MRD negativity is associated with better outcomes when giving hyperCVAD. Thus, in my practice, I assess for MRD after recovery from cycl...