MRD-Guided Therapy Across Hematologic Malignancies: Endpoints, Harmonisation, and Clinical Decisions

Measurable residual disease (MRD) has emerged as one of the most informative biomarkers across hematologic malignancies, spanning acute myeloid leukemia and myelodysplastic syndromes, chronic lymphocytic leukemia, lymphoma, and multiple myeloma. Advances in flow cytometry, next-generation sequencing, digital PCR, and circulating tumor DNA assays now allow disease burden to be quantified with a sensitivity that morphological remission criteria cannot match. Yet each disease area has developed its own assays, thresholds, and reporting conventions largely in isolation. As MRD testing moves from research settings into routine clinical practice and increasingly into regulatory and reimbursement decisions, the field faces a pressing need to compare approaches across malignancies, identify shared principles, and build frameworks that translate MRD results into consistent, actionable clinical decisions.This Research Topic aims to bring together cross-disease perspectives on how MRD is measured, interpreted, and acted upon in hematologic malignancies. A central problem is that assay platforms differ in sensitivity, turnaround time, and cost, and thresholds for MRD positivity are rarely harmonized even within the same disease, let alone across AML, CLL, lymphoma, and myeloma. We aim to address how recent advances in flow cytometry, NGS, and ctDNA-based detection can be compared and reconciled, how MRD status can inform treatment intensification, de-escalation, or maintenance strategies, and how trial design and regulatory or payor frameworks are adapting to MRD as an endpoint. Contributions that draw parallels across disease areas, propose harmonization strategies, or report real-world implementation experience are particularly encouraged.This Research Topic welcomes contributions across the full spectrum of hematologic malignancies where MRD assessment informs clinical decision-making, with an emphasis on cross-disease comparison and practical implementation.We welcome Original Research, Review, Mini Review and Perspective articles on themes including, but not limited to:- Cross-disease MRD use cases and clinical decision frameworks in AML/MDS, CLL, lymphoma, and myeloma- Assay harmonization and reporting standards, including flow cytometry, NGS, and ctDNA, and their comparability across platforms and thresholds- MRD as a trial endpoint, including regulatory, payor, and real-world implementation pathwaysPlease note: manuscripts consisting solely of bioinformatics or computational analysis of sole public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic. Topic editors: Anna Sicuranza, Zachary Epstein-Peterson Source: https://www.frontiersin.org/research-topics/80953/mrd-guided-therapy-across-hematologic-malignancies-endpoints-harmonisation-and-clinical-decisions