Minimal Residual Disease in Acute Lymphoblastic Leukemia
Once patient of acute lymphoblastic leukemia (ALL) is in clinical remission, more sensitive tools than morphology are required to assess minimal residual disease (MRD), to guide clinicians in management of the disease. In the present time, MRD assessment by flow cytometry and molecular methods has emerged as the single most useful prognostic factor in ALL. The chapter deals with definition, technique, utility, and prognostic implications of MRD measurement in ALL.
KeywordsAcute lymphoblastic leukemia Minimal residual disease Morphological remission Relapse Hematogones Leukemia associated immunophenotype Polymerase chain reaction
- 6.Borowitz MJ, Devidas M, Hunger SP, Bowman WP, Carroll AJ, Carroll WL, et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children’s Oncology Group study. Blood. 2008;111(12):5477–85.CrossRefGoogle Scholar
- 15.McPherson R, Pincus M. Henry’s clinical diagnosis and management by laboratory methods E-book. Philadelphia: Elsevier Health Sciences; 2016.Google Scholar
- 20.6 flow cytometry gating tips that most scientists forget|expert cytometry|flow cytometry training [internet]. Expert cytometry. 2014 [cited 2017 Dec 18]. https://expertcytometry.com/6-flow-cytometry-gating-tips-that-most-scientists-forget/.
- 21.Ghodke K, Bibi A, Rabade N, Patkar N, Subramanian PG, Kadam PA, et al. CD19 negative precursor B acute lymphoblastic leukemia (B-ALL)-immunophenotypic challenges in diagnosis and monitoring: a study of three cases: CD19 negative precursor B-ALL-immunophenotypic challenges in diagnosis and monitoring. Cytometry B Clin Cytom. 2017;92(4):315–8.CrossRefGoogle Scholar
- 24.Gleissner B, Rieder H, Thiel E, Fonatsch C, Janssen LA, Heinze B, et al. Prospective BCR-ABL analysis by polymerase chain reaction (RT-PCR) in adult acute B-lineage lymphoblastic leukemia: reliability of RT-nested-PCR and comparison to cytogenetic data. Leukemia. 2001;15(12):1834–40.CrossRefGoogle Scholar
- 25.Mitterbauer G, Nemeth P, Wacha S, Cross NC, Schwarzinger I, Jaeger U, et al. Quantification of minimal residual disease in patients with BCR-ABL-positive acute lymphoblastic leukaemia using quantitative competitive polymerase chain reaction. Br J Haematol. 1999 Sep;106(3):634–43.CrossRefGoogle Scholar
- 26.Flohr T, Schrauder A, Cazzaniga G, Panzer-Grümayer R, van der Velden V, Fischer S, et al. Minimal residual disease-directed risk stratification using real-time quantitative PCR analysis of immunoglobulin and T-cell receptor gene rearrangements in the international multicenter trial AIEOP-BFM ALL 2000 for childhood acute lymphoblastic leukemia. Leukemia. 2008;22(4):771–82.CrossRefGoogle Scholar
- 27.Vora AJ, Goulden N, Mitchell CD, Hough R, Rowntree C, Richards SM. UKALL 2003, a randomised trial investigating treatment intensification for children and young adults with minimal residual disease defined high risk acute lymphoblastic leukaemia. Blood. 2012;120(21):136.Google Scholar