Vedula Rahul S, Lindsley R Coleman
Dana-Farber Cancer Institute, 450 Brookline Ave., DA-530C, Boston, MA, 02115, USA.
Curr Hematol Malig Rep. 2017 Dec;12(6):574-581. doi: 10.1007/s11899-017-0428-4.
Assessment of measurable residual disease (MRD) after treatment can identify patients with acute myeloid leukemia (AML) that are at high risk of poor outcomes. However, there is no consensus yet regarding a standardized approach to measuring MRD that is most clinically meaningful. We review multiparameter flow cytometry (MFC) and reverse transcriptase polymerase chain reaction (RT-PCR), and discuss a framework for assessing remission MRD using next-generation sequencing (NGS).
MFC and RT-PCR may not fully capitalize on the major advances that have been made in characterizing the genetic landscape of AML, which has offered insight into the biological and clinical implications of clonal genetic architecture. NGS has increasingly been shown to provide a qualitative and quantitative assessment of MRD with significant prognostic implications. The assessment of clonal architecture by NGS may complement or extend existing approaches for MRD monitoring. Long-term serial monitoring of diagnostic, remission, and relapse samples with clinical correlation will need to be performed in order to determine the impact of various MRD patterns using this technique.
治疗后可测量残留病（MRD）的评估能够识别急性髓系白血病（AML）患者中预后不良风险较高的患者。然而，对于最具临床意义的MRD测量标准化方法尚未达成共识。我们回顾了多参数流式细胞术（MFC）和逆转录聚合酶链反应（RT-PCR），并讨论了使用下一代测序（NGS）评估缓解期MRD的框架。
MFC和RT-PCR可能未充分利用AML基因图谱特征方面取得的重大进展，这些进展为克隆基因结构的生物学和临床意义提供了见解。越来越多的研究表明，NGS能够对MRD进行定性和定量评估，具有显著的预后意义。通过NGS对克隆结构进行评估可能会补充或扩展现有的MRD监测方法。需要对诊断、缓解期和复发样本进行长期的系列监测，并与临床情况相关联，以确定使用该技术的各种MRD模式的影响。
