The EuroMRD network, formerly known as the European Study Group on MRD detection in ALL (ESG-MRD-ALL), was established in 2001 and is currently composed of 69 MRD-PCR laboratories spread across 26 countries in Europe, Asia, Australia, North and South America.
The technical strategies developed in the EU-supported BIOMED-1 Concerted Action: "International standardization and evaluation of techniques for the detection of MRD in acute non-lymphocytic leukemia" (EU-DGXII grant: BMH1-CT94-1675) and in the International BFM Study Group (I-BFM-SG) formed the basis of the EuroMRD network.
The main aims of EuroMRD are:
- Organization of ALL (IG/TCR, MLL), NHL (BCL1/2, IGH) and Ph+ALL (BCR-ABL) RQ-PCR-based MRD Quality Assessment (QA) programs twice per year;
- Collaborative development and evaluation of new MRD strategies and techniques, such as ddPCR and NGS;
- Development of guidelines for the interpretation of RQ-PCR-based MRD data as well as those covering new strategies and techniques.
ESLHO is an official EHA Specialized Working Group (SWG). SWGs seek to initiate and create scientific networks that serve under the umbrella of EHA. At the annual EHA Congress, ESLHO presents its innovations in the special EHA-SWG sessions.
RQ-PCR MRD detection as basis for risk stratification in ALL patients
Several studies have shown that detection of minimal residual disease (MRD) in childhood and adult acute lymphoblastic leukemia (ALL) is clinically relevant. Consequently, MRD diagnostics is currently incorporated in many childhood and adult ALL treatment protocols for stratification into several treatment arms. In most MRD-based stratification studies, MRD is analyzed by real-time quantitative-polymerase chain reaction (RQ-PCR) analysis of ‘leukemia-specific’ junctional regions of rearranged immunoglobulin (Ig) genes, T-cell receptor (TCR) genes or other patient-specific DNA targets.
To ensure comparable MRD results between different MRD-PCR laboratories, standardization and quality assessment are essential. EuroMRD has developed guidelines for the interpretation of RQ-PCR MRD data. The application of these guidelines ensures identical interpretation of MRD data between different laboratories of the same MRD-based clinical protocol. Furthermore, the EuroMRD guidelines facilitate the comparison of MRD data obtained in different treatment protocols, including those that evaluate new drugs, where MRD might be used as primary endpoint.