Minimal residual disease

Monitoring of residual disease in patients with malignant hematologic disorders has been recognized as an important diagnostic tool for assessment of the response to treatment and the individual risk of relapse. In a number of malignancies, employment of sensitive techniques permitting the identification of tumor cells within a 10(4)-fold or greater excess of normal cells revealed that the presence and persistence of residual disease at this level does not necessarily imply inevitable relapse. Several studies demonstrated that surveillance of persisting neoplastic cells by quantitative techniques can provide prognostically relevant information on the sensitivity of the malignant population to the treatment applied and the biologic behavior of the residual tumor cell clone during and after therapy. It has been shown in different types of leukemia that investigation of the level or the dynamics of residual disease by sensitive and quantitative approaches can provide a basis for clinical decision making.