UCSF Helen Diller Family Comprehensive Cancer Center, Department of Medicine, Division of Hematology and Blood and Marrow Transplantation, University of California, San Francisco.
Clin Adv Hematol Oncol. 2020 Jul;18(7):413-422.
Measurable residual disease (MRD) quantification is an essential component of caring for patients with acute lymphoblastic leukemia (ALL). Many studies in pediatric and adult populations have validated the prognostic significance of MRD early in and throughout the course of treatment for ALL, and it is generally accepted that achievement of MRD less than 10[-4] (0.01%) is a critical milestone. ALL is uniquely amenable to quantification of MRD by multiple techniques, including multiparameter flow cytometry, various allele-specific and mutation-specific quantitative polymerase chain reaction methods, and more recently amplicon-based next-generation sequencing. Quantification of MRD with these high-sensitivity methods not only facilitates risk stratification, but also is used to determine appropriateness of intensified therapy, such as allogeneic hematopoietic cell transplant, as well as MRD-targeted therapy with blinatumomab. We review the data supporting the use of MRD quantification in ALL to guide clinical decision-making.
残留疾病（MRD）定量检测是急性淋巴细胞白血病（ALL）患者治疗护理的重要组成部分。许多儿科和成人患者的研究均证实，MRD 定量检测在 ALL 治疗过程中的早期及全程具有预后价值，并且普遍认为，MRD 小于 10[-4]（0.01%）是一个关键的里程碑。ALL 特别适合通过多种技术进行 MRD 定量检测，包括多参数流式细胞术、各种等位基因特异性和突变特异性定量聚合酶链反应方法，以及最近的基于扩增子的下一代测序。这些高灵敏度方法的 MRD 定量检测不仅有助于风险分层，还可用于确定强化治疗的适宜性，如异基因造血细胞移植，以及针对残留疾病的治疗，如blinatumomab。我们综述了支持使用 MRD 定量检测来指导 ALL 临床决策的相关数据。
