title: MRD in AML: it is time to change the definition of remission.
abstract: The possibility of defining residual disease far below the morphological level of 5% blast cells is changing the landscape of risk classification in acute myeloid leukemia (AML). The so-called minimal residual disease (MRD) approach at this time can establish the presence of leukemia cells down to levels of 1:1000-1:10(6) white blood cells, compared to 1:20 for morphology. Availability of the newer and more sensitive technology to quantify the level of leukemic burden raises the issue of whether MRD should emerge as a new definition of complete response. This paper explores some of the issues surrounding such a change in definition.
authors.affiliation: Department of Hematology, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: G.Ossenkoppele@vumc.nl.
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.affiliation: Department of Hematology, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: Gerrit Jan
authors.initials: GJ
authors.lastname: Schuurhuis
mesh_terms: D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods*; D018365:Neoplasm, Residual
keywords: LAIP, leukemia associated immunophenotype; MRD; PCR, polymerase chain reaction; acute myeloid leukemia, AML; complete response, CR; flow; minimal residual disease; morphology; real-time quantitative PCR, RQ-PCR; risk classification; transplant