Is MRD status the first thing to change when someone relapses?

So is MRD status the first thing to change when someone relapses? So in theory, yes. And that's because as AML relapses, the burden of disease will slowly increase from undetectable to MRD positive and then ultimately an overt relapse with circulating leukemia cells, for example. However, in practice, we often don't pick up relapses with initial MRD testing prior to the relapse. And the reason for that is simple is that we don't typically get bone marrows in patients in remission more than every three to six months. So sometimes we miss that. However, it certainly can be the case that in a routine surveillance bone marrow, a patient is noted who was initially in a good remission to be MRD positive. And that would certainly be a sign or that would be concerning for an impending relapse. And that's something that a leukemia doctor would likely want to initiate some new therapy for that patient.