title: Introducing minimal residual disease in acute myeloid leukemia.
abstract: OBJECTIVE
  Acute myeloid leukemia (AML) is a heterogeneous disease. Detection of minimal residual disease (MRD) has the potential to improve risk stratification, and its routine monitoring may allow timely therapeutic actions such as allogeneic hematopoietic stem cell transplantation. The current review will discuss challenges and available evidence for clinical application of MRD detection in AML management.
  
  
  RESULTS
  The heterogeneous nature of AML, variations in genetic aberrations and immunophenotypes among patients and between malignant subclones coexisting within a single patient, is a challenge for the development of a reliable MRD test in AML. MRD value was demonstrated in subtypes of AML in which reliable leukemia-specific genetic marker is present (e.g., core-binding leukemia, AML positive for NPM1 mutation). Multicolor flow cytometry and quantitative PCR monitoring for Wilms tumor 1 gene transcript have also been shown to correlate with disease progression. MRD results should always be interpreted within patient-specific clinical context considering other risk factors and timing of MRD eradication.
  
  
  CONCLUSIONS
  Introduction of MRD testing into routine clinical practice is a challenge in AML. An improvement in laboratory techniques along with identification of additional leukemia-specific markers is required.
authors.affiliation: aDepartment of Hematology and Bone Marrow Transplantation, Rambam Healthcare Campus, Haifa bDepartment of Hematology, Shaare Zedek Medical Center, Jerusalem cBruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Yishai
authors.initials: Y
authors.lastname: Ofran
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Rowe
mesh_terms: D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology; D019468:Disease Management; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D018365:Neoplasm, Residual / Q000175:diagnosis*; D000090243:Nucleophosmin; D016133:Polymerase Chain Reaction; D012074:Remission Induction; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C000716967:NPM1 protein, human; D000090243:Nucleophosmin