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Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives

Li Wei1*,Zhang Ming2 ORCID 

¹ Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China.
² Department of Hematology, National Cancer Center/National Clinical Research Center for
Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
DOI: 10.18081/ajbm.2026.3.194

Publication History: Received 12 May 2026, Revised 27 June 2026, Accepted 11 July 2026, Available online 30 July 2026
Copyright: © 2026 Wei, et al. This is an open-access article under a Creative Commons license (CC BY 4.0).
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ABSTRACT

Measurable residual disease (MRD) has become a cornerstone of modern acute myeloid leukemia (AML) management, fundamentally transforming disease monitoring, prognostic stratification, and therapeutic decision-making. Although conventional morphologic assessment remains the standard for evaluating remission, it lacks the sensitivity required to detect low levels of persistent leukemia that frequently precede clinical relapse. Over the past decade, remarkable advances in immunophenotypic, molecular, and genomic technologies have substantially improved the accuracy and clinical utility of MRD assessment. Multiparameter flow cytometry and quantitative real-time polymerase chain reaction continue to represent the most widely implemented approaches in routine practice, while digital droplet polymerase chain reaction and error-corrected next-generation sequencing provide enhanced analytical sensitivity for molecular monitoring. More recently, single-cell sequencing, multi-omics technologies, liquid biopsy, and artificial intelligence–based analytical platforms have emerged as promising strategies for characterizing clonal evolution, leukemia stem cell persistence, treatment resistance, and individualized relapse risk. These innovations are driving the transition from static disease assessment toward dynamic precision monitoring throughout the entire treatment course, including induction therapy, consolidation, allogeneic hematopoietic stem cell transplantation, and post-transplant surveillance. Nevertheless, important challenges remain, including assay standardization, optimal MRD thresholds, discrimination between residual leukemia and clonal hematopoiesis, interlaboratory reproducibility, cost, and integration of multiple diagnostic platforms into routine clinical workflows. This review provides a comprehensive overview of the biological basis of MRD, critically examines current and emerging detection technologies, summarizes their clinical applications and limitations, and discusses future directions for MRD-guided precision medicine in AML. The continued integration of highly sensitive molecular diagnostics, single-cell and multi-omics profiling, liquid biopsy, and artificial intelligence is expected to redefine risk-adapted therapeutic strategies and further improve long-term outcomes for patients with AML.

Keywords: Acute myeloid leukemia; Measurable residual disease; Multiparameter flow cytometry; Molecular monitoring; Digital droplet polymerase chain reaction.

Recommended Citation

Wei L, Ming Z. Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives. Advanced Journal of Biomedicine & Medicine. 2026;14(3):194-220. doi:10.18081/ajbm.2026.3.194

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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2026 Vol 14, Issue 3 Pages 194-220

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Wei L, Ming Z (2026). Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives. Advanced Journal of Biomedicine & Medicine, 14(3), 194-220. https://doi.org/10.18081/ajbm.2026.3.194
Wei L, Ming Z. " Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives." Advanced Journal of Biomedicine & Medicine, vol. 14, no. 3, 2026, pp. 194-220. DOI: 10.18081/ajbm.2026.3.194.
Wei L, Ming Z. Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives. AJBM. 2026;14(3):194-220. DOI: 10.18081/ajbm.2026.3.194. PMID: .
Wei L, Ming Z 2026, " Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives", Advanced Journal of Biomedicine & Medicine, vol. 14, no. 3, pp. 194-220.
@article{wei2026, title={ Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives}, author={Wei L, Ming Z}, journal={Advanced Journal of Biomedicine & Medicine}, volume={14}, number={3}, pages={194-220}, year={2026}, doi={10.18081/ajbm.2026.3.194} }
TY - JOUR AU - Wei L, Ming Z TI - Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives JO - American Journal of Biomedicine VL - 14 IS - 3 SP - 194-220 PY - 2026 DO - 10.18081/ajbm.2026.3.194 ER -
%0 Journal Article %A Wei L, Ming Z %T Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives %J American Journal of Biomedicine %V 14 %N 3 %P 194-220 %D 2026 %R 10.18081/ajbm.2026.3.194 %M
Wei L, Ming Z (2026). Measurable Residual Disease in Acute Myeloid Leukemia: State-of-the-Art Technologies, Clinical Applications, and Future Perspectives. Advanced Journal of Biomedicine & Medicine, 14(3), 194-220. https://doi.org/10.18081/ajbm.2026.3.194

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