title: Monitoring minimal residual disease in acute leukemia: Technical challenges and interpretive complexities.
abstract: Minimal residual disease (MRD) after therapy has unequivocal prognostic value in acute leukemia. Over the past 20years, a number of techniques have evolved into routine laboratory tools to detect MRD, most notably, multiparametric flow cytometry (MFC) and quantitative polymerase chain reaction (PCR)-based molecular methods. There is growing evidence that the presence of MRD detected by MFC or molecular methods provides independent prognostic information and is associated with an increased risk of relapse and shortened survival. However, the predictive value of MRD may be affected by a lack of consensus as to the timing for assessment, the methodology used, and interlaboratory variation in test performance. Herein, we review the methodological principles of MRD assays, discuss the clinical implications of monitoring MRD for risk stratification and directing further therapy, and suggest potential areas for future investigation.
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Xueyan
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA; Seattle Cancer Care Alliance, Seattle, WA, USA. Electronic address: woodbl@u.washington.edu.
authors.forename: Brent L
authors.initials: BL
authors.lastname: Wood
mesh_terms: D015415:Biomarkers; D000066491:Clinical Decision-Making; D005434:Flow Cytometry / Q000379:methods / Q000592:standards; D006801:Humans; D016130:Immunophenotyping / Q000379:methods / Q000592:standards; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D018365:Neoplasm, Residual / Q000175:diagnosis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods / Q000592:standards; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
keywords: Acute leukemia; Flow cytometry; Minimal residual disease; Quantitative PCR