Campana D, Coustan-Smith E
Department of Hematology-Oncology, Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
Cytometry. 1999 Aug 15;38(4):139-52. doi: 10.1002/(sici)1097-0320(19990815)38:4<139::aid-cyto1>3.0.co;2-h.
Patients with acute leukemia in clinical remission may still have up to 10(10) residual malignant cells (the upper limit of detection by standard morphologic techniques). Sensitive techniques to detect minimal residual disease (MRD) may allow better estimates of the leukemia burden and help the selection of appropriate therapeutic strategies. Flow cytometry and polymerase chain reaction have emerged as the most promising methods for detecting submicrospopic levels of leukemia. Flowcytometric detection of MRD is based on the identification of immunophenotypic combinations expressed on leukemic cells but not on normal hematopoietic cells. It affords the detection of one leukemic cell among 10,000 normal bone marrow cells, and can be currently applied to at least two thirds of all patients with acute leukemia. Prospective studies in large series of patients have demonstrated a strong correlation between MRD levels during clinical remission and treatment outcome. Therefore, MRD assays can be reliably used to assess early response to treatment and predict relapse. In this review, we discuss methodologic aspects and clinical results of flowcytometric detection of MRD in patients with acute leukemia.
处于临床缓解期的急性白血病患者可能仍有多达10¹⁰个残留恶性细胞（标准形态学技术的检测上限）。检测微小残留病（MRD）的敏感技术可能有助于更准确地评估白血病负荷，并有助于选择合适的治疗策略。流式细胞术和聚合酶链反应已成为检测亚微观水平白血病最有前景的方法。MRD的流式细胞术检测基于识别白血病细胞上表达但正常造血细胞上不表达的免疫表型组合。它能够在一万个正常骨髓细胞中检测出一个白血病细胞，目前可应用于至少三分之二的急性白血病患者。对大量患者的前瞻性研究表明，临床缓解期的MRD水平与治疗结果之间存在密切关联。因此，MRD检测可可靠地用于评估治疗的早期反应并预测复发。在本综述中，我们讨论了急性白血病患者MRD流式细胞术检测的方法学方面和临床结果。
