Clinical applicability of the evaluation of minimal residual disease in acute leukemia

Modern chemotherapy can place most patients with acute leukemia into remission. Unfortunately, many of these patients will subsequently relapse. The study of minimal residual disease focuses on the detection of patients destined to relapse despite appearing to be in clinical remission. In addition, the research has demonstrated that some patients appear to co-exist with their leukemia for years, and this suggests a need to re-examine what it means to be "cured" of leukemia. We await trials testing the intervention of "molecular relapse." Data appear to be sufficient to launch such trials in diseases such as pediatric acute lymphoblastic leukemia and the t(15;17) acute myeloid leukemia. (C) 2000 Lippincott Williams & Wilkins, Inc.