El Chaer Firas, Perissinotti Anthony J, Loghavi Sanam, Zeidan Amer M
Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA.
Department of Clinical Pharmacy, Michigan Medicine and the University of Michigan College of Pharmacy, Ann Arbor, MI, USA.
Leukemia. 2025 Jan;39(1):1-7. doi: 10.1038/s41375-024-02458-6. Epub 2024 Nov 5.
The use of measurable residual disease (MRD) as a biomarker for prognostication, risk stratification, and therapeutic decision-making in acute myeloid leukemia (AML) is gaining prominence. MRD monitoring for NPM1-mutated and core-binding factor AML using PCR techniques is well-established for assessing disease after intensive chemotherapy. AML with persistent FLT3-ITD MRD post-intensive chemotherapy and pre-allogeneic hematopoietic cell transplantation (pre-allo-HCT) is associated with an increased risk of relapse and lower survival. Pre-allo-HCT MRD is an independent risk factor for post-allo-HCT outcomes, including relapse and death. Therefore, preemptive interventions on the natural history of MRD positivity are an active area of research beyond its initial prognostic function. Targeting MRD in AML with innovative treatment strategies can improve patient outcomes.
将可测量残留病（MRD）用作急性髓系白血病（AML）预后、风险分层和治疗决策的生物标志物正日益受到关注。使用PCR技术对NPM1突变型和核心结合因子AML进行MRD监测，在评估强化化疗后的疾病情况方面已得到充分确立。强化化疗后及异基因造血细胞移植前（allo-HCT前）持续存在FLT3-ITD MRD的AML与复发风险增加和生存率降低相关。allo-HCT前的MRD是allo-HCT后结局（包括复发和死亡）的独立危险因素。因此，针对MRD阳性自然病程的抢先干预是超出其初始预后功能的一个活跃研究领域。采用创新治疗策略靶向AML中的MRD可改善患者结局。
