Haema 2017; 8(2): 179-187
by Christina Papadaki1, Maria Garofalaki2, Aikaterini Psarra3
1Haematology, “G. Gennimatas” General Hospital of Athens,
2Mol Biology Lab, Haematology – Lymphomas Department and Bone Marrow Transplantation Unit, “Evangelismos” Hospital of Athens,
3Immunology-Histocompatibility Department, “Evangelismos” Hospital of Athens, Greece
Abstract
A lot of effort has been made to identify prognostic risk factors and evaluate the prognostic value of minimal residual disease (MRD) monitoring, in acute myeloid leukemia (AML). Detection of MRD is of major importance since it evaluates the “depth” of the remission and therefore, risk adapted therapy based on early detection of relapse becomes feasible. Laboratory techniques such as flow cytometry and polymerase chain reaction (PCR) allow measurement of remaining leukemic cells below the morphological sensitivity. The current review discuss flow cytometric immunophenotyping (MFC) and quantitative PCR (RT-qPCR), their characteristics, advantages and disadvantages in MRD detection, as well as the available trials for clinical application of these methods for MRD detection. Nevertheless MRD directed therapy at the moment is restricted to acute promyelocytic leukemia, since differences in the assays, lack of standardized MRD thresholds and MRD time, makes clinical utility of MRD monitoring limited although it is already implemented worldwide. Thus more studies are needed to further explore its clinical utility, to standardize relevant assays in order to help to identify the group of patients at higher risk of relapse and to make therapeutic interventions accordingly.