Division of Hematology/Department of Medicine, The Ohio State University - The James Comprehensive Cancer Center, Columbus, OH; Department of Biomedical Informatics, The Ohio State University, Columbus, OH.
Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA; Division of Hematology/Department of Medicine, University of Washington, Seattle, WA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA.
Haematologica. 2022 Dec 1;107(12):2810-2822. doi: 10.3324/haematol.2022.282034.
Considerable progress has been made in the past several years in the scientific understanding of, and available treatments for, acute myeloid leukemia (AML). Achievement of a conventional remission, evaluated cytomorphologically via small bone marrow samples, is a necessary but not sufficient step toward cure. It is increasingly appreciated that molecular or immunophenotypic methods to identify and quantify measurable residual disease (MRD) - populations of leukemia cells below the cytomorphological detection limit - provide refined information on the quality of response to treatment and prediction of the risk of AML recurrence and leukemia-related deaths. The principles and practices surrounding MRD remain incompletely determined however and the genetic and immunophenotypic heterogeneity of AML may prevent a one-sizefits- all approach. Here, we review the current approaches to MRD testing in AML, discuss strengths and limitations, highlight recent technological advances that may improve such testing, and summarize ongoing initiatives to generate the clinical evidence needed to advance the use of MRD testing in patients with AML.
在过去的几年中，人们在急性髓系白血病（AML）的科学认识和现有治疗方法方面取得了相当大的进展。通过小骨髓样本进行细胞形态学评估达到常规缓解是治愈的必要但非充分步骤。人们越来越认识到，用于识别和量化可测量残留疾病（MRD）——低于细胞形态学检测限的白血病细胞群体——的分子或免疫表型方法可提供有关治疗反应质量和 AML 复发及白血病相关死亡风险预测的更精细信息。然而，围绕 MRD 的原则和实践仍未完全确定，并且 AML 的遗传和免疫表型异质性可能会阻止一刀切的方法。在这里，我们回顾了 AML 中 MRD 检测的当前方法，讨论了它们的优缺点，强调了可能改善此类检测的最新技术进步，并总结了正在进行的计划，以生成推进 AML 患者 MRD 检测使用所需的临床证据。
