What is NGS testing? Do children receive this testing? NGS, or next generation sequencing, is a type of molecular test where you're looking in a very detailed zoomed in manner at the genome or the genetic material that makes up your leukemia to look for mutations. And this has been looked at in research labs to learn more about the genetics of leukemia, but it's also now being examined to look for very, very tiny amounts of leukemia in the body. After we finish treating someone with chemotherapy, we look to see if there's any leukemia left in the body, and that's looking for what's called MRD, or minimal residual disease. Ideally, we don't want to find any. Over time, our tools to look for minimal residual disease have gotten better and better. It used to be a few decades ago that what you would do is just look under the microscope and see, do I see any leukemia cells? Of course, the human eye is only so good at detecting a single leukemia cell, for example. The next phase of detecting minimal residual disease was to do flow cytometry, which is a laboratory test where they look at various markers on the cell surface. So the sensitivity of a computer, a machine, the flow cytometer, to pick up tiny, tiny amounts of leukemia cells is much better than the human eye. So that became the standard for looking for minimal residual disease. The current wave of technology development is going even further than flow cytometry, and that's the next generation sequencing. So using what we know about the genetics of the leukemia, we can look for even smaller and smaller amounts of leukemia left in the body, which may help us determine the trajectory of someone's treatment. Does this person require more chemotherapy? How deep is their remission? That sort of thing. Yes. Most hospitals that are treating oncology patients will do their own flow cytometry testing, although there are centralized laboratories that people also send flow cytometry testing to. So yes, MSK has their own flow cytometry lab, which will look at whatever type of cell you're trying to detect, whether it's a myeloma cell or a leukemia cell, they can detect the various markers on the cell surface using the flow cytometer.
