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

被引:92
作者
Szczepanski, T.
机构
[1] Med Univ Silesia, Dept Pediat Hematol & Oncol, PL-41800 Zabrze, Poland
[2] Univ Rotterdam, Med Ctr, Erasmus MC, Dept Immunol, Rotterdam, Netherlands
关键词
acute lymphoblastic leukemia; minimal residual disease; flow cytometric immunophenotyping; real-time polymerase chain reaction; immunoglobulin and T-cell receptor genes; fusion genes;
D O I
10.1038/sj.leu.2404603
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:622 / 626
页数:5
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