Molecular monitoring during the treatment of patients with haematological malignancies provides valuable information to allow stratification of therapy and to determine the efficacy of treatment. Molecular monitoring provided by the Oncology Genomics section includes:
Minimal Residual Disease (MRD) analysis
In ALL, MRD is now well established as the most powerful prognostic factor in predicting outcome in infant, paediatric and adult ALL allowing for risk group stratification into different treatment arms, ranging from significant treatment reduction to treatment intensification.
BGL is one of the six laboratories in the UK who provide MRD analysis to support the current clinical trial in paediatric ALL (UKALL 2011). In addition, BGL is the national MRD centre for international clinical trials in infant (Interfant-06) and relapsed (IntReALL) ALL, which both include MRD-based treatment stratification.
Furthermore, BGL provides MRD analysis to aid in the clinical management of patients for a variety of reasons including those receiving bone marrow transplantation for high-risk or relapsed disease and for patients with refractory ALL undergoing novel therapies including CAR T-cell therapy and antibody-based immunotherapies.
The Oncology Genomics section also provides molecular monitoring of response for patients undergoing tyrosine kinase inhibitor (TKI) therapy in CML. The molecular monitoring of response will be particularly important in the era where the discontinuation of therapy (treatment free remission) is becoming a treatment goal in CML.
BGL provides results generated on the International Scale and produces fully interpretive reports according to the ELN guidelines for management of CML.
To allow full interpretation of results, we request that clinical centres provide adequate information regarding the type and duration of TKI therapy.
BGL also provides ABL kinase domain mutation testing for patients if treatment resistance or disease recurrence occurs.
Last Updated 7th August 2017