[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-405790-105":59,"doc-detail-405790-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","measurable-residual-disease-monitoring-after-hematopoietic-stem-cell-transplantation","Measurable residual disease monitoring after hematopoietic stem cell transplantation","","Measurable residual disease (MRD) monitoring is presented as an essential component of post–hematopoietic stem cell transplantation surveillance, enabling risk stratification and guiding therapeutic decisions. Persistent MRD carries strong prognostic significance, and technological advances plus quality assurance improve clinical precision. MRD is defined as leukemic cells below morphologic detection, and its interpretation after allogeneic HSCT is shaped by donor–recipient chimerism, immune reconstitution, graft-versus-leukemia/graft-versus-host balance, and MRD kinetics during engraftment and immunosuppression tapering. Optimal MRD approaches require high analytical sensitivity, broad applicability, reproducibility, standardized protocols, and rapid turnaround, with quantitative methods favored.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/measurable-residual-disease-monitoring-after-hematopoietic-stem-cell-transplantation/405790/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/measurable-residual-disease-monitoring-after-hematopoietic-stem-cell-transplantation/405790.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is measurable residual disease (MRD) in the post-transplant setting?","Question",{"text":112,"@type":113},"MRD refers to residual leukemic cells present below the detection threshold of conventional morphological assessment by microscopy. After HSCT, MRD interpretation must consider donor–recipient chimerism, immune reconstitution, and the dynamic balance of graft-versus-leukemia and graft-versus-host disease.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why does MRD after allogeneic HSCT differ from MRD monitoring during conventional chemotherapy?",{"text":117,"@type":113},"Post-HSCT MRD interpretation is influenced by transplant-specific factors such as chimerism and immune reconstitution, as well as MRD kinetics around engraftment and during immunosuppression tapering. These lead to distinct prognostic implications compared with non-transplant settings.",{"name":119,"@type":110,"acceptedAnswer":120},"What sensitivity and practical features should an ideal MRD monitoring method have?",{"text":121,"@type":113},"An optimal method should achieve at least 10–3 sensitivity (detecting one cancer cell among 1,000 normal cells), with even higher sensitivity (10–4 to 10–6) preferred clinically. It should be widely applicable, reproducible across laboratories, support standardized protocols, and deliver rapid turnaround. Quantitative MRD is favored over qualitative methods.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},405790,1790763369,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":39,"preview_page_count":4},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","Shin Blood Research (2025) 60:66  \n[https://doi.org/10.1007/s44313-025-00121-2](https://doi.org/10.1007/s44313-025-00121-2)  \nBlood Research  \n CORRESPONDENCE Open Access  \nMeasurable residual disease monitoring   after hematopoietic stem cell transplantation  \nSaeam Shin1*  \nTo the Editor:  \nMeasurable residual disease (MRD) monitoring has become integral to post-transplant surveillance in hematologic malignancies, providing critical guidance for risk stratification and therapeutic decision-making following allogeneic hematopoietic stem cell transplantation (HSCT). Persistent MRD post-HSCT has a strong prognostic value, and early detection can inform timely therapeutic interventions [1]. Recent advances in technology and quality assurance have enhanced the precision and clinical applicability of MRD assessment.  \nMRD refers to the presence of residual leukemic cells below the detection threshold of conventional morphologic evaluation using microscopy, and its assessment is now standard in the management of hematologic malignancies including acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). MRD monitoring after allogeneic HSCT, however, differs in several important aspects from MRD assessment during conventional chemotherapy or pre-transplant evaluation. In the posttransplant setting, MRD must be interpreted in the context of donor–recipient chimerism, immune reconstitution, and the dynamic balance between graft-versusleukemia and graft-versus-host disease, and the kinetics of MRD around engraftment and during immunosuppression tapering have distinct prognostic implications compared with non-transplant settings [2].  \nOptimal techniques for MRD monitoring should possess a sensitivity of at least 10–3, meaning the ability to  \n*Correspondence: Saeam Shin [saeam0304@yuhs.ac](saeam0304@yuhs.ac)  \n1 Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea  \ndetect a single cancer cell among 1,000 normal cells. However, methods with higher sensitivity, ranging from 10–4 to 10–6, are preferred in clinical practice to ensure reliable identification of residual disease and early recurrence. The ideal approach should be widely applicable across diverse patient populations, reproducible among different laboratories, and amenable to straightforward standardization protocols. Furthermore, rapid turnaround times for results are essential for timely clinical decision-making and intervention. Quantitative MRD assessment is preferred over qualitative methods.  \nMRD can be detected using several advanced technologies, each with distinct advantages and limitations (Table 1). Multiparameter flow cytometry (MFC) employs two main principal approaches for MRD detection: leukemia-associated aberrant immunophenotype (LAIP) and the different-from-normal (DfN) method [3]. MFC is widely applicable across various leukemia subtypes and rapidly provides results with sensitivity typically ranging from 10–3 to 10–4; next-generation flow cytometry can further increase sensitivity up to 10–6, although interpretative variability remains a challenge. In ALL, the EuroFlow Consortium has established a standardized operating procedure for flow cytometric MRD assessment in B-cell precursor ALL (BCP-ALL), employing two 8-color antibody tubes for comprehensive detection [4]. Their protocol enables staining and acquisition of large numbers of cells—exceeding 4 million per sample—achieving a sensitivity of 10–5 (0.001%) and ensuring applicability in over 98% of patients. This approach has set a benchmark for harmonized, high-sensitivity MRD detection in BCP-ALL.  \nQuantitative real-time PCR (qPCR) and digital PCR (dPCR) achieve high sensitivity—up to 10–5 or 10–6—but are restricted to patients who have appropriate  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-","cbCaidBNV0YGLtdB","https://ap.wps.com/l/cbCaidBNV0YGLtdB","pdf",889907,"English","# Introduction\n## Definition and clinical significance of MRD\n# Post-HSCT considerations\n# Requirements for optimal MRD techniques\n# Technologies for MRD detection\n## Multiparameter flow cytometry (MFC)\n## qPCR and digital PCR (dPCR)\n## Next-generation sequencing (NGS)\n# Comparative characteristics (Table 1)","[{\"question\":\"What is measurable residual disease (MRD) in the post-transplant setting?\",\"answer\":\"MRD refers to residual leukemic cells present below the detection threshold of conventional morphological assessment by microscopy. After HSCT, MRD interpretation must consider donor–recipient chimerism, immune reconstitution, and the dynamic balance of graft-versus-leukemia and graft-versus-host disease.\"},{\"question\":\"Why does MRD after allogeneic HSCT differ from MRD monitoring during conventional chemotherapy?\",\"answer\":\"Post-HSCT MRD interpretation is influenced by transplant-specific factors such as chimerism and immune reconstitution, as well as MRD kinetics around engraftment and during immunosuppression tapering. These lead to distinct prognostic implications compared with non-transplant settings.\"},{\"question\":\"What sensitivity and practical features should an ideal MRD monitoring method have?\",\"answer\":\"An optimal method should achieve at least 10–3 sensitivity (detecting one cancer cell among 1,000 normal cells), with even higher sensitivity (10–4 to 10–6) preferred clinically. It should be widely applicable, reproducible across laboratories, support standardized protocols, and deliver rapid turnaround. Quantitative MRD is favored over qualitative methods.\"}]","Measurable residual disease monitoring after hematopoietic stem cell transplantation | PDF",1790561838]