Clinician-friendly reports of molecular measurable residual disease monitoring in acute promyelocytic leukemia

Ann Hematol. 2019 Oct;98(10):2347-2355. doi: 10.1007/s00277-019-03782-z. Epub 2019 Aug 24.

Abstract

Molecular measurable residual disease (MRD) monitoring based on real-time quantitative reverse transcription PCR (RT-qPCR) plays an important role in acute promyelocytic leukemia (APL) management, but the performance status of clinical reports is unknown. This study focuses on the specific elements in molecular MRD monitoring report and their impact on clinical decision-making. The participating laboratories were asked to submit real and formal clinical reports for mock samples panel with APL clinical case. The MRD-specific elements were analyzed and summarized. The significance of longitudinal MRD monitoring curve and the missing MRD-specific elements for clinical decision-making were assessed. MRD-specific elements were significantly missing in clinical reports. The element "testing results" existed great inconsistencies in the written form of testing items and data. The longitudinal MRD monitoring curve of false-negative or false-positive MRD result was obviously different from all-correct. It not only identified MRD time point of tissue sampling relative to treatment and ensured the reliability of the negative MRD results, but also gave MRD diagnosis, clinical interpretation, and further recommendation. Clinician-friendly reports with MRD-specific elements can better serve clinical practice. The correctly intuitive results and clinically important MRD-specific elements can provide a good description of the reliability and clinical significance of MRD results.

Keywords: Acute promyelocytic leukemia; Clinician-friendly reports; Measurable residual disease; Molecular MRD monitoring; PML/RARA.

MeSH terms

  • Electronic Health Records*
  • Humans
  • Leukemia, Promyelocytic, Acute* / blood
  • Leukemia, Promyelocytic, Acute* / genetics
  • Monitoring, Physiologic / methods
  • Neoplasm, Residual
  • Real-Time Polymerase Chain Reaction / methods*