Current ALL Practice

Acute Lymphoblastic Leukemia (ALL) patients are treated according to their risk for relapse, which is determined by minimal residual disease (MRD) lab tests. MRD meausures the small numbers of leukaemic cells (cancer cells from the bone marrow) that remain in the patient during treatment, between treatment cycles or after treatment.  MRD has become a crucial component of ALL patients’ clinical management.

Minimal Residual Test

The goal of MRD assessment is to detect and quantify patients’ risk to relapse (return of disease) and to determine the intensity of the ALL patients’ treatment. Thus, maximizing chances of cure and minimizing toxic therapeutic side-effects. MRD is a powerful and independent predictor of ALL patients’ relapse free survival, however certain difficulties exist.

MRD is a treatment response test, so the patient's first treatment cycle, induction therapy, usually does not take in consideration the patient's risk for relapse.  

According to which treatment protocol is administered, personalized treatment decisions based on MRD tests are first taken around 4 - 12 weeks from diagnosis after induction therapy.

MRD tests are highly patient specific taking up to 16 days or over 80 different reactions, to decipher leukemic factors in PCR -MRD assessment. Following the MRD test is designed for each patient.

There is a concern of false negative results in the long-term monitoring of MRD, because of undetected changes in the ALL patient’s specific leukemia cell clone.  

It is difficult to standardize MRD tests, thus only very few laboratories perform this very highly specialized test.


The ProALL Lab test is a ground breaking standard lab test that reveals patients risk for relapse near diagnosis and adds unique prognostic information not found in MRD tests.