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Why and how to quantify minimal residual disease in acute lymphoblastic leukemia?

Leukemia volume 21, pages 622–626 (2007)Cite this article

Abstract

Several studies have demonstrated that monitoring of minimal residual disease (MRD) in childhood and adult acute lymphoblastic leukemia (ALL) significantly correlates with clinical outcome. MRD detection is particularly useful for evaluation of early treatment response and consequently for improved front-line therapy stratification. MRD information is also significant for children undergoing allogeneic hematopoietic stem cell transplantation and those with relapsed ALL. Currently, three highly specific and sensitive methodologies for MRD detection are available, namely multiparameter flow cytometric immunophenotyping, real-time quantitative polymerase chain reaction (RQ-PCR)-based detection of fusion gene transcripts or breakpoints, and RQ-PCR-based detection of clonal immunoglobulin and T-cell receptor gene rearrangements. In this review, characteristics, pitfalls, advantages and disadvantages of each MRD technique are critically discussed. The special emphasis is put on interlaboratory standardization, especially in view of the results obtained within the European collaborative BIOMED-1, BIOMED-2, and Europe Against Cancer projects and recent developments by European Study Group on MRD detection in ALL and EuroFlow Consortium. Standardized MRD techniques form the basis for stratification of patients into the risk groups in new treatment protocols mainly in childhood ALL. Only the results of these studies can answer the question whether MRD-based treatment intervention is associated with improved outcome.

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Acknowledgements

The author is supported by scientific Grants number 2P054 095 30 and 3PO5E 094 25 from the Polish Ministry of Science and Higher Education.

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  1. Department of Pediatric Hematology and Oncology, Silesian Medical Academy, Zabrze, Poland

    T Szczepański

  2. Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

    T Szczepański

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Szczepański, T. Why and how to quantify minimal residual disease in acute lymphoblastic leukemia?. Leukemia 21, 622–626 (2007). https://doi.org/10.1038/sj.leu.2404603

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