[Minimal residual disease in AML]
1Department of Pediatrics, Shiga University of Medical Science.
Abstract:
Minimal (measurable) residual disease (MRD) in acute leukemia denotes the presence of leukemic cells detected by multiparameter flow cytometry or various molecular techniques in patients achieving hematological remission. The MRD become an independent, post-diagnosis, prognostic indicator important for risk stratification and treatment planning, in conjunction with other well-established clinical, cytogenetic, and molecular data assessed at diagnosis in acute myeloid leukemia (AML). However, several issues remain with regard to the ideal time point to measure MRD, the clinically significant threshold, the sample (peripheral blood or bone marrow) should be used, and the standardize tests, so that results from different laboratories become comparable. This review gives an overview of the currently available evidence regarding technical issues, prognostic impact, and MRD-directed treatment for AML.
Insights
Minimal residual disease (MRD) monitoring in acute myeloid leukemia (AML) aids prognosis and treatment planning. Standardization of MRD testing is crucial for comparable results and effective patient risk stratification.
Area of Science:
- Hematology
- Oncology
- Clinical Diagnostics
Background:
- Minimal residual disease (MRD) refers to undetectable leukemic cells post-treatment.
- MRD is a key prognostic factor in acute myeloid leukemia (AML), aiding risk stratification.
- Current challenges include standardizing MRD measurement timing, thresholds, and sample types.
Purpose of the Study:
- To review current evidence on technical aspects of MRD detection in AML.
- To discuss the prognostic impact of MRD in AML.
- To explore MRD-directed treatment strategies for AML.
Main Methods:
- Review of existing literature on MRD detection and its clinical utility in AML.
- Analysis of technical considerations for multiparameter flow cytometry and molecular techniques.
- Evaluation of studies correlating MRD levels with patient outcomes.
Main Results:
- MRD detection via flow cytometry or molecular methods is vital post-remission.
- MRD serves as an independent prognostic indicator for AML risk stratification.
- Standardization of MRD assessment (timing, thresholds, sample type) is needed for inter-laboratory comparability.
Conclusions:
- MRD monitoring is essential for personalized AML treatment planning.
- Addressing technical standardization issues will enhance the clinical utility of MRD in AML.
- Further research into MRD-directed therapies is warranted for improved AML management.
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