MRD in AML: it is time to change the definition of remission

Gert J Ossenkoppele; Gerrit Jan Schuurhuis

doi:10.1016/j.beha.2014.10.008

MRD in AML: it is time to change the definition of remission

Best Pract Res Clin Haematol. 2014 Sep-Dec;27(3-4):265-71. doi: 10.1016/j.beha.2014.10.008. Epub 2014 Oct 15.

Authors

Gert J Ossenkoppele¹, Gerrit Jan Schuurhuis²

Affiliations

¹ Department of Hematology, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: G.Ossenkoppele@vumc.nl.
² Department of Hematology, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

PMID: 25455276
DOI: 10.1016/j.beha.2014.10.008

Abstract

The possibility of defining residual disease far below the morphological level of 5% blast cells is changing the landscape of risk classification in acute myeloid leukemia (AML). The so-called minimal residual disease (MRD) approach at this time can establish the presence of leukemia cells down to levels of 1:1000-1:10(6) white blood cells, compared to 1:20 for morphology. Availability of the newer and more sensitive technology to quantify the level of leukemic burden raises the issue of whether MRD should emerge as a new definition of complete response. This paper explores some of the issues surrounding such a change in definition.

Keywords: LAIP, leukemia associated immunophenotype; MRD; PCR, polymerase chain reaction; acute myeloid leukemia, AML; complete response, CR; flow; minimal residual disease; morphology; real-time quantitative PCR, RQ-PCR; risk classification; transplant.

Publication types

Review

MeSH terms

Humans
Leukemia, Myeloid, Acute / therapy*
Monitoring, Physiologic / methods*
Neoplasm, Residual*