Monitoring and managing minimal residual disease in acute lymphoblastic leukemia.

In adult acute lymphoblastic leukemia (ALL) the complete remission (CR) rates have improved to 85% to 90%. Despite this high CR rate, 40% to 50% of patients eventually relapse. This occurs because of the limited sensitivity of cytomorphology in assessing complete molecular remission. Thus, more sensitive methods that detect leukemic cells on a molecular level and identify minimal residual disease are needed.