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Strategies for minimal residual disease detection: current perspectives

Authors
  • Andreani, Giacomo1
  • Cilloni, Daniela1
  • 1 Department of Clinical and Biological Sciences, University of Turin, Turin , (Italy)
Type
Published Article
Journal
Blood and Lymphatic Cancer: Targets and Therapy
Publisher
Dove
Publication Date
Feb 12, 2019
Volume
9
Pages
1–8
Identifiers
DOI: 10.2147/BLCTT.S172693
PMID: 31807111
PMCID: PMC6855617
Source
PubMed Central
Keywords
License
Green

Abstract

Currently, the post-remission treatment in acute leukemia is based on the genetic profile of leukemic cells at diagnosis (ie, FLT3 ITD positivity) and on the level of measurable residual disease (MRD) after induction and consolidation chemotherapy. Two methods are currently preferred for MRD evaluation in many centers: multiparameter flow cytometry and real-time quantitative PCR. Additional methods such as next-generation sequencing and digital PCR are under investigation, in an attempt to increase the sensitivity and thus allowing the detection of small clones. Many studies suggest that MRD positivity after chemotherapy is associated with negative prognosis, and the reappearance of MRD during follow-up allows impending relapse to be identified and consequently enables early intervention. Finally, MRD positivity before hematopoietic stem cell transplantation is predictive of the outcome. Although the significance of MRD in acute leukemia has been widely explored, the assessment of molecular MRD is not yet a routine practice. In this review, we describe the significance of MRD in different settings and the main markers and methods used for MRD detection.

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