Chatterjee T, Mallhi R S, Venkatesan S
Commandant, 166 Military Hospital, C/o 56 APO, India.
Professor, Department of Immunohaematology & Blood Transfusion, Armed Forces Medical College, Pune 411040, India.
Med J Armed Forces India. 2016 Apr;72(2):152-6. doi: 10.1016/j.mjafi.2016.02.002. Epub 2016 Mar 29.
Minimal residual disease (MRD) describes disease that can be diagnosed by methodologies other than conventional morphology, and includes molecular methods (like polymerase chain reaction (PCR)) or flow cytometry (FCM). Detection and monitoring of MRD is becoming the standard of care, considering its importance in predicting the treatment outcome. MRD aids in identifying high-risk patients and hence therapy can be intensified in them while deintensification of therapy can prevent long-term sequelae of chemotherapy in low-risk category. FCM is considered as a less labor-intensive and faster MRD technique as compared to PCR although it has its own share of disadvantages. Current immune-based methodologies for detection of MRD depend on establishing leukemia-associated aberrant immunophenotype (LAIP), at diagnosis or relapse and use this information at specified time points for detection of MRD, or apply a standardized panel of antibody combinations for all MRD cases, in a different-from-normal approach. This review highlights MRD detection by FCM and its application in acute leukemia.
微小残留病(MRD)指的是可通过传统形态学以外的方法诊断出的疾病,包括分子方法(如聚合酶链反应(PCR))或流式细胞术(FCM)。鉴于MRD在预测治疗结果方面的重要性,对其进行检测和监测正成为治疗的标准。MRD有助于识别高危患者,因此可对他们强化治疗,而对于低风险患者,减少治疗强度可预防化疗的长期后遗症。与PCR相比,FCM被认为是一种劳动强度较低且速度更快的MRD检测技术,尽管它也有自身的缺点。目前基于免疫的MRD检测方法依赖于在诊断或复发时确定白血病相关异常免疫表型(LAIP),并在特定时间点利用该信息检测MRD,或者以一种不同于正常情况的方法,为所有MRD病例应用标准化的抗体组合面板。本综述重点介绍了通过FCM检测MRD及其在急性白血病中的应用。