About EuroMRD

The EuroMRD network, formerly known as the European Study Group on MRD detection in ALL (ESG-MRD-ALL), was established in 2001 and has grown into a global consortium of 69 MRD-PCR laboratories across 26 countries in Europe, Asia, Australia, and North and South America. What began as a European initiative to standardize RQ-PCR-based MRD detection in childhood ALL has evolved into an internationally recognized framework for MRD quality assurance and guideline development applicable across ALL subtypes and a range of detection technologies.

EuroMRD's scientific foundations were established through two landmark initiatives. The EU-supported BIOMED-1 Concerted Action (EU-DGXII grant BMH1-CT94-1675) developed and internationally standardized techniques for MRD detection in acute lymphocytic leukemia, establishing the technical principles of IG/TCR gene rearrangement-based RQ-PCR that remain central to clinical MRD diagnostics today. In parallel, the International BFM Study Group (I-BFM-SG) developed clinical protocols that incorporated MRD-guided treatment stratification, creating the need for rigorous inter-laboratory comparability that EuroMRD was specifically organized to address.

The founding insight of EuroMRD was that MRD data can only be clinically actionable if a result from one laboratory means the same as a result from another — regardless of which primer set or thermocycler was used, or which operator performed the analysis”. Achieving that comparability requires not only technical standardization but ongoing quality assessment, transparent guidelines for data interpretation, and a community of practice that can collectively develop and validate new approaches as the field evolves.

EuroMRD's quality assessment (QA) program is one of the longest-running and most comprehensive external quality assurance schemes in molecular oncology diagnostics. Organized twice per year, each QA round distributes standardized sample materials to all participating laboratories, who analyze the samples according to their routine protocols and report their results to the EuroMRD coordination center.

Results are evaluated against established performance criteria, and each laboratory receives individual feedback together with an anonymized overview of all participants' results. This process enables laboratories to benchmark their performance, identify technical issues, and maintain the level of analytical quality required for EuroMRD participantship and, in many cases, for certification within their national clinical trial protocols.

QA rounds currently cover the following MRD targets:

• ALL: IG/TCR gene rearrangements and KMT2A (MLL) rearrangements
• NHL: BCL1/IGH and BCL2/IGH rearrangements
• Ph+ALL: BCR-ABL1 fusion transcripts

Laboratories participating in each QA round contribute to a shared dataset that informs EuroMRD's ongoing guideline development and supports the field's understanding of inter-laboratory variability in MRD measurement.

While RQ-PCR remains the established standard for IG/TCR-based MRD detection, EuroMRD has been actively engaged in the evaluation and standardization of two emerging technologies: digital droplet PCR (ddPCR) and next-generation sequencing (NGS)-based MRD detection.

ddPCR offers potential advantages in absolute quantification without the need for standard curves, and may improve sensitivity and reproducibility at low MRD levels. EuroMRD has been coordinating collaborative studies to evaluate the concordance of ddPCR and RQ-PCR results and to assess whether ddPCR-specific guidelines for data interpretation are needed.

NGS-based MRD detection enables simultaneous analysis of multiple clonal targets with high throughput and, in some settings, higher sensitivity. EuroMRD is involved in efforts to define quality standards, reporting frameworks, and interpretation criteria for NGS-MRD, recognizing that the transition from research to clinical application requires the same kind of inter-laboratory standardization that was central to the success of RQ-PCR-based MRD.

EuroMRD operates as an independent scientific network governed by its participating laboratories. Scientific decisions, guideline development, and QA program design are managed through the EuroMRD board and relevant working groups, which meet twice annually.

EuroMRD is supported by ESLHO (European Scientific foundation for Laboratory Hemato-Oncology), alongside the EuroFlow and EuroClonality consortia. Since December 2025, the organization of EuroMRD's external quality assurance schemes has been formally adopted by ESLHO, aligning EuroMRD's QA activities with those of the broader ESLHO consortium.

ESLHO is an official Specialized Working Group (SWG) of the European Hematology Association (EHA). At the annual EHA Congress, ESLHO presents scientific advances from EuroMRD and its sister consortia in dedicated SWG sessions.

EuroMRD is also supported by Leukaemia & Lymphoma Research (Blood Cancer UK) and EuroClonality.