2019 Volume 8 Issue 1 Pages 1-8
With developments of flow cytometry (FCM) for detecting cells with leukemia-associated phenotypes and of polymerase chain reactions to detect leukemia specific DNA or chimeric mRNA, it has become possible to detect leukemic cells with sensitivity of 10-5 in many adult patients with Philadelphia-chromosome (Ph) -negative acute lymphoblastic leukemia. A state in which leukemic cells are not detected by such a highly sensitive method is called immunophenotypic, or molecular complete remission (CR). A leukemic burden that exists between hematological CR and immunophenotypic/molecular CR is called minimal residual disease (MRD). The significance of MRD varies depending on therapy protocol used, time points, and measurement methods.
MRD response during chemotherapy is the strongest overall prognostic indicator in adult Ph (−) ALL patients.
Post-induction MRD-negative patients have been identified to have good prognosis with chemotherapies, not suitable for up-front allogeneic hematopoietic stem cell transplantation.
