Department of Medicine II, University of Schleswig-Holstein, Kiel, Germany.
Blood Rev. 2011 Mar;25(2):91-6. doi: 10.1016/j.blre.2011.01.001. Epub 2011 Jan 26.
Allogeneic stem cell transplantation (alloSCT) is a potentially curative treatment strategy for poor-risk chronic lymphocytic leukemia (CLL). The crucial anti-leukemic principle of alloSCT in CLL appears to be the graft-versus-leukemia effect (GVL). Evidence for GVL in CLL is particularly provided by studies analysing the kinetics of minimal residual disease (MRD). The purpose of this review is to summarize the methodologies of MRD assessment, its proven benefits and its further perspectives for optimizing the outcome of transplantation. Proven value of quantitative MRD monitoring by RQ-PCR or MRD-flow consists in using it as an indicator of long-term disease control and potential cure. As MRD kinetics correlates with GVL activity, its suitability for guiding GVL-inducing immunomodulation is currently under investigation. In conclusion, quantitative MRD monitoring seems to be mandatory to assure safe and effective immunotherapy in the context of alloSCT for CLL, which should, however, be best performed within clinical studies.
异基因造血干细胞移植（alloSCT）是一种治疗高危慢性淋巴细胞白血病（CLL）的潜在根治方法。alloSCT 在 CLL 中的关键抗白血病原理似乎是移植物抗白血病效应（GVL）。在 CLL 中提供 GVL 证据的研究尤其通过分析微小残留病（MRD）动力学来提供。本综述的目的是总结 MRD 评估的方法学、其已证实的益处以及进一步优化移植结果的前景。通过 RQ-PCR 或 MRD-flow 进行定量 MRD 监测的已证实价值在于将其用作长期疾病控制和潜在治愈的指标。由于 MRD 动力学与 GVL 活性相关，因此目前正在研究其作为指导 GVL 诱导免疫调节的适用性。总之，定量 MRD 监测似乎是确保 alloSCT 治疗 CLL 时安全有效的免疫治疗的必要条件，但最好在临床研究中进行。
