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Leukemia is a cancer of the blood cells, and acute lymphoblastic leukemia comprises nearly 80% of childhood leukemia cases.

Patients diagnosed with acute lymphoblastic leukemia receive treatment that is tailored according to their chance of suffering a relapse. Despite treatment advances in recent decades, nearly a quarter of all patients with acute lymphoblastic leukemia still suffer relapse after remission. Relapse is thought to result from residual leukemic cells that persist after treatment. This low level of leukemic cells is known as minimal residual disease.

Testing for minimal residual disease involves the detection of tiny amounts of cancer cells in the bone marrow. Depending on whether minimal residual disease is found and at what level, treatment might be adjusted to help children have the best outcomes possible.

OntarioHealth completed a health technology assessment to examine the relationship between minimal residual disease and chance of relapse, as well as the effect of using minimal residual disease tests to tailor treatment. Health Quality Ontario also worked with the Toronto Health Economics and Technology Assessment Collaborative to determine the costs of minimal residual disease testing and to assess the test’s value for money.