Eradicating measurable residual disease via immunotherapy to cure acute lymphoblastic leukemia: current status and future directions.

INTRODUCTION

Eradicating measurable residual disease (MRD) may represent the final hurdle in curing ALL. The introduction of immunotherapies alone or in combination with other agents to therapies, including induction therapy, consolidation therapy, maintenance therapy, preemptive therapy and salvage therapy, was superior to chemotherapy alone in eradicating MRD during the course of treatment, leading to improved survival.

AREAS COVERED: We provide a concise overview of the techniques used for MRD detection. We focus on the application of immunotherapies for MRD eradication at different treatment timepoints, and the factors associated with poor outcomes in patients receiving immunotherapies. We also discuss the underlying mechanisms of immunotherapy resistance in leukemia. Additionally, we highlight the importance of characterizing residual disease and designing prospective clinical trials, as these efforts may contribute to the development of novel immunotherapies and help determine which currently available immunotherapies are most effective.

EXPERT OPINION: Immunotherapies represent a breakthrough and are currently changing the status quo of ALL therapy. Future research should focus on biomarker-directed individual immunotherapy, mechanism-driven development of new therapies, and clinical trials to identify the best immunotherapy.