New approaches for the detection of minimal residual disease in acute myeloid leukemia.
The detection of minimal residual disease (MRD) in patients with acute leukemia has been studied for about 15 years by different groups in both the United States and Europe. It has been found that MRD detection can be performed using molecular and immunophenotypic aberrancies that are present in the leukemic clone at diagnosis and not in normal bone marrow. When performing MRD assessments after chemotherapy, it is possible to identify patients at risk for relapse. This review is not an overview of all MRD studies, but rather discusses the possibilities for optimizing MRD detection, the use of flow cytometry versus polymerase chain reaction techniques, and the implications for future patient treatment. When informative, we compare literature on MRD in acute myeloid leukemia (AML) with information from MRD studies in acute lymphoblastic leukemia. Finally, we address the promising detection of AML stem cells, the likely cells of origin in AML, for prediction of clinical outcome and guidance of future therapies.
van Rhenen
Anna
A
VU University Medical Center, CCA 4.24, De Boelelaan 1117,1081 HV Amsterdam, The Netherlands.
Moshaver
Bijan
B
Ossenkoppele
Gert J
GJ
Schuurhuis
Gerrit Jan
GJ
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics; D001856:Bone Marrow Examination; D002648:Child; D002986:Clinical Trials as Topic; D002999:Clone Cells / Q000737:chemistry / Q000473:pathology; D004252:DNA Mutational Analysis; D005434:Flow Cytometry; D005544:Forecasting; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D015337:Multicenter Studies as Topic; D009363:Neoplasm Proteins / Q000235:genetics; D018365:Neoplasm, Residual; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins