Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Laboratory of Molecular Biology, National Cancer Institute, NIH, Bethesda, MD, USA.
Blood Cancer J. 2022 Dec 13;12(12):165. doi: 10.1038/s41408-022-00760-z.
A significant body of literature has been generated related to the detection of measurable residual disease (MRD) at the time of achieving complete remission (CR) in patients with hairy cell leukemia (HCL). However, due to the indolent nature of the disease as well as reports suggesting long-term survival in patients treated with a single course of a nucleoside analog albeit without evidence of cure, the merits of detection of MRD and attempts to eradicate it have been debated. Studies utilizing novel strategies in the relapse setting have demonstrated the utility of achieving CR with undetectable MRD (uMRD) in prolonging the duration of remission. Several assays including immunohistochemical analysis of bone marrow specimens, multi-parameter flow cytometry and molecular assays to detect the mutant BRAF V600E gene or the consensus primer for the immunoglobulin heavy chain gene (IGH) rearrangement have been utilized with few comparative studies. Here we provide a consensus report on the available data, the potential merits of MRD assessment in the front-line and relapse settings and recommendations on future role of MRD assessment in HCL.
大量文献探讨了毛细胞白血病（HCL）患者达到完全缓解（CR）时可测量残留病（MRD）的检测。然而，由于该病的惰性性质，以及有报道称，尽管没有治愈证据，但接受单一疗程核苷类似物治疗的患者仍能长期生存，因此检测 MRD 并试图消灭它的价值一直存在争议。在复发情况下利用新策略进行的研究表明，达到可检测到的 MRD（uMRD）的 CR 可延长缓解持续时间。已经使用了几种检测方法，包括骨髓标本的免疫组织化学分析、多参数流式细胞术和用于检测突变 BRAF V600E 基因或免疫球蛋白重链基因（IGH）重排的共识引物的分子检测，但比较研究较少。在这里，我们提供了一份关于现有数据的共识报告，讨论了在一线和复发情况下进行 MRD 评估的潜在价值，并就 MRD 在 HCL 中的未来作用提出了建议。
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