Abstract
Mature B cell disorders have recently become highly curable diseases thanks to the introduction of new treatment strategies; nonetheless, despite evidence of complete remission, many patients affected by lymphoma or myeloma eventually relapse and need salvage therapy. Minimal residual disease (MRD) detection and quantification is a powerful tool to evaluate treatment efficacy, to stratify patients, and to predict long-term outcome. In fact, in the current landscape of novel, highly efficacious but toxic and often costly targeted therapies, early identification of factors predictive of treatment response or refractoriness is the key to avoid overtreatment of patients and thus also to reduce costs for health care system.
In this article we reviewed the prognostic role of MRD in follicular lymphoma, mantle cell lymphoma and multiple myeloma. We analyzed published clinical studies and available methodologies, and we described the major ongoing studies of MRD-driven tailored treatment in these diseases. Finally, we discussed novel applications and techniques for MRD identification in hematologic malignancies and future directions of MRD-oriented research. In particular, we hypothesized some possible, next-generation, precision medicine trials in lymphoproliferative diseases based on the most promising currently available biomarkers.