2025 Volume 14 Issue 4 Pages 229-233
Measurable residual disease (MRD) assessment in acute myeloid leukemia (AML) has become increasingly important for optimizing treatment strategies, including allogeneic hematopoietic stem cell transplantation (allo-HSCT). We are currently developing a simultaneous MRD evaluation system combining leukemia-associated immunophenotype (LAIP) and TIM-3 (T-cell immunoglobulin mucin-3)-positive leukemia stem cell (LSC) quantification. In our retrospective analysis, eradication of TIM-3＋ LSCs prior to allo-HSCT was associated with improved treatment outcomes. Furthermore, therapeutic approaches targeting TIM-3＋ LSCs are under investigation, aiming to eliminate chemoresistant clones while preserving normal hematopoiesis. By integrating quantitative MRD assessment based on TIM-3 expression and targeted therapy directed at residual LSCs, this strategy offers a novel approach to relapse control in AML. Even with allo-HSCT, the presence of residual TIM-3＋ LSCs may lead to relapse, underscoring the importance of their eradication. The combination of single-tube flow cytometric monitoring and LSC-targeted therapy may enable a new therapeutic paradigm in which residual disease becomes not only measurable but actionable.
