The detection of minimal residual disease in acute lymphoblastic leukaemia

The detection of minimal residual disease in acute lymphoblastic leukaemia (ALL) can be achieved by assessing leukaemia-specific features at a cellular, chromosomal or molecular level. The application of the polymerase chain reaction to the amplification of leukaemia-specific chromosomal translocations and clone-specific immunoglobulin and T-cell receptor gene rearrangements allows assessment of the majority of cases of ALL. The sensitivity of detection of this technique is around one leukaemia cell in 10(5) normal marrow cells. A comparative review of the advantages and pitfalls of the different methods of detecting minimal disease is presented. The clinical relevance of such detection is discussed, with early results suggesting that this may have predictive value for future disease relapse.