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流细胞计和分子MRD在AML:当前的方法,临床应用和挑战

Lukas H Haaksma^1,2, Jacqueline Cloos^1,2, David C de Leeuw^1,2

¹Department of Hematology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Leukemia & lymphoma

|August 20, 2025

概括

在急性髓性白血病 (AML) 中,可测量的残留疾病 (MRD) 监测有助于个性化治疗. 检测MRD诱导后治疗可以改进整合策略,从而改善患者的治疗结果.

科学领域:

血液学
癌症学
临床诊断

背景情况:

在急性髓性白血病 (AML) 中,可测量的残留疾病 (MRD) 提供了超出初始诊断的预后见解.
在诱导治疗后缓解的MRD患者的监测对于个性化治疗至关重要.

研究的目的:

对缓解期AML患者的MRD检测的临床实施进行审查.
讨论MRD在指导整合治疗中的作用,包括全源干细胞移植的决定.
突出MRD评估中的挑战和未来方向.

主要方法:

对AML检测现有临床实践和文献的审查.
讨论三种主要MRD检测方法:多参数流细胞计 (MFC),聚合酶链反应 (PCR) 和下一代测序 (NGS).
对每个MRD检测方法的预后值,强度和局限性的分析.

主要成果:

对MRD的评估提供了补充分子风险分类的预后信息.
监测MRD可以指导治疗强化或减强的决定,包括全源干细胞移植.
证据支持MRD在选择调节强度,干细胞来源和预巩固疗法方面的有用性.

结论:

实验室对MRD检测方法的标准化和协调仍然是一个关键挑战.
结合不同的MRD检测方法可以利用它们各自的优势来提高临床效用.
持续的研究和国际合作对于优化MRD在AML管理中的作用至关重要.

关键词:

急性骨髓性白血病生物标志物可测量的残留疾病多参数流细胞计下一代测序聚合酶连锁反应

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相关概念视频

Flow Cytometry

Flow Cytometry

The development of flow cytometry techniques began in 1934 with initial attempts by Andrew Moldavan, a bacteriologist who counted the cells in a flowing capillary system. Moldavan pumped cells through a capillary tube focused under a microscope for visualization. The invention of photometry allowed the measurement of differentially-stained cells, and Louis Kamentsky developed the first multiparameter flow cytometer in 1965 to identify and count the cancer cells in cervical tissue specimens.
In...