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Shrinidhi Nathany: MRD in AML – From a Test to a Treatment Decision

Shrinidhi Nathany/LinkedIn

Dec 16, 2025, 23:14

Shrinidhi Nathany: MRD in AML – From a Test to a Treatment Decision

Shrinidhi Nathany, Consultant Molecular Hematology and Oncology at Fortis Memorial, posted on LinkedIn:

“MRD in AML: From a Test to a Treatment Decision (ELN-DAVID 2025 Update)

Measurable residual disease (MRD) has firmly moved beyond being a laboratory metric.
The 2025 ELN-DAVID consensus update positions MRD as a central clinical decision-making tool in acute myeloid leukemia.

What’s new and practice-changing?

MRD interpretation is now genetics-specific, aligned with ELN 2022 risk groups
Introduction of low-level MRD (MRD-LL) and qualitative MRD response categories – Optimal, Warning, High-risk
Clear linkage of MRD results to clinical action, not just prognosis
Ultra-high-sensitivity NGS (≤0.01%) now recommended for FLT3-ITD MRD, especially pre-transplant
Refined, lower thresholds for NPM1 MRD, with clear PB vs BM distinctions
Explicit caution against misinterpreting CHIP-associated mutations as MRD

Why this matters

MRD is no longer binary. The same MRD level can mean very different things depending on:
genetics, assay, tissue, and timing.
This framework finally brings context and clarity to MRD-guided decisions.

For clinicians, pathologists, and transplant teams, this update is a must-read and should rapidly translate into:
standardized reporting, multidisciplinary discussion, and more precise patient care.”

Stay informed with Hemostasis Today.