We Want to Say Thank You: The MLL Annual Review for 2021

In our practice, the MLL MVZ, and in the MLL Munich Leukemia Laboratory, this year has been marked by the covid pandemic – just as it has been for everyone. This has fueled our concern for the patients treated in our practice and affected our entire team. With considerable additional efforts directed toward sanitary measures and vaccination programs both for our patients and our team, we have tried as to minimize the level of uncertainty and insecurity as much as possible. Among other things, this has gained us a vaccination rate of over 90% among our staff and enabled us to vaccinate more than 850 friends of the MLL team as part of a comprehensive vaccination program offered by the MLL MVZ.

Our primary goal at the MLL has been to offer state-of-the-art diagnostics at all times – with short diagnosis times. Along with initiating organizational measures, in part due to staff shortages related to necessary self-quarantining, we have also taken many other steps at the MLL: To the extent permitted by workplace requirements, working at home has been greatly expanded and incorporated within a regular structure. Every procedure has been assessed for its capacity to be digitalized and automated and gradually improved to make the processes even more efficient overall. We are working hard to make our digital Symptoms Query platform and Order Entry System available to all submitters. Using them is of course free of charge. We are adapting and expanding our website for all types of digital communication and information. We are also rapidly incorporating the results of our research into routine diagnostics.

Meriting special mention is the fact that the overall number of samples has increased on average by 15% in 2021 compared to the previously best year of 2020. The growth in molecular genetics was higher than normal, not only in terms of sample numbers, but also with respect to the increasingly complex requirements associated with panel sequencing. For the first time, we have been able to incorporate Whole Genome Sequencing (WGS) into the routine of our hematologically focused evaluation algorithms, especially for very complex cases. One such program (”The Difficult Case”) is also available to submitters free of charge as part of our research domain.

In 2021, we have once again been able to contribute to a large number of scientific collaborations worldwide, with both presentations at international and national congresses as well as publications. The data from our routine diagnostics is therefore being used for research projects – in compliance with strict data protection requirements – and publications, resulting in leukemia diagnostics and increasingly specific therapies based on it that are effective long-term, for the benefit of the individual patient.

In routine diagnostics and pilot studies, the use of artificial intelligence (AI) is standard at the MLL for the fields of cytomorphology (peripheral blood and bone marrow differentiation), traditional cytogenetics, 24-color FISH, immunophenotyping, and genome and transcriptome sequencing. We are undertaking large research projects in these areas, including MetaSystems and AWS, which are already assisting us greatly in our daily routine and which will continue to provide a wealth of contributions in the near future. Next year, we will also be involving beta testers from other laboratories so that the products created using AI can be used outside of the MLL as well.

In 2021, we were also accredited by the CAP (College of American Pathologists) for the first time. And, for the third time in a row, we were lauded as a Top 100 Innovator among German SMEs. It continues to be our primary and also future objective to offer state-of-the-art leukemia and lymphoma diagnostics with fast turnaround times for findings reports.

The new WHO leukemia and lymphoma classification planned for next year, which we have been permitted to collaborate on for the first time as MLL authors, will greatly help all of us in hematology to arrive at an even better understanding of hematological diseases and the therapies used to treat them. We are pursuing this objective more than ever at the MLL: to quickly make the increasingly comprehensive and specific diagnostic findings – especially from cytogenetics and molecular genetics – directly available to every single patient for classification, prognosis assessment, and targeted therapy (precision medicine). This is increasingly the case with “measurable residual disease” (MRD), which is playing an ever greater role in therapy management.

We want to thank all of our employees for their excellent work this year despite the challenging circumstances with which we all have to live right now. We also want to thank our submitters for the trust they place both in and in our diagnostics. Finally, we are grateful to all of our partners for their constructive collaboration, even in times of delivery bottlenecks.

It remains our common goal to use the results of our diagnostics to extend lives and increase healing rates.

We wish you all a peaceful Christmas season and, for all of us, a much more positive outlook for the year 2022.

With best regards,

Prof. Dr. med. Claudia Haferlach
Prof. Dr. med. Dr. phil. Torsten Haferlach
Prof. Dr. med. Wolfgang Kern