Prognostic and therapeutic implications of minimal residual disease detection in acute myeloid leukemia

Author:

Buccisano Francesco1,Maurillo Luca1,Del Principe Maria Ilaria1,Del Poeta Giovanni1,Sconocchia Giuseppe2,Lo-Coco Francesco13,Arcese William1,Amadori Sergio1,Venditti Adriano1

Affiliation:

1. Hematology, Fondazione Policlinico Tor Vergata, Rome, Italy;

2. Institute of Translational Pharmacology, Department of Medicine, CNR, Rome, Italy; and

3. Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy

Abstract

The choice of either induction or postremission therapy for adults with acute myeloid leukemia is still largely based on the “one size fits all” principle. Moreover, pretreatment prognostic parameters, especially chromosome and gene abnormalities, may fail in predicting individual patient outcome. Measurement of minimal residual disease (MRD) is nowadays recognized as a potential critical tool to assess the quality of response after chemotherapy and to plan postremission strategies that are, therefore, driven by the individual risk of relapse. PCR and multiparametric flow cytometry have become the most popular methods to investigate MRD because they have been established as sensitive and specific enough to allow MRD to be studied serially. In the present review, we examine the evidence supporting the appropriateness of incorporating MRD detection into the AML risk assessment process. A comprehensive prognostic algorithm, generated by combining pretreatment cytogenetics/genetics and posttreatment MRD determination, should promote advances in development of personalized therapeutic approaches.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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