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The Prognostic Significance of Measurable (“Minimal”) Residual Disease in Acute Myeloid Leukemia

  • Acute Myeloid Leukemias (H Erba, Section Editor)
  • Published:
Current Hematologic Malignancy Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review was to evaluate recent literature on detection methodologies for, and prognostic significance of, measurable (“minimal”) residual disease (MRD) in acute myeloid leukemia (AML).

Recent Findings

There is no “one-fits-all” approach to MRD testing in AML. Most exploited to date are methods relying on immunophenotypic aberrancies (identified via multiparameter flow cytometry) or genetic abnormalities (identified via PCR-based assays). Current methods have important shortcomings, including the lack of assay platform standardization/harmonization across laboratories. In parallel to refinements of existing technologies and data analysis/interpretation, new methodologies (e.g., next-generation sequencing-based assays) are emerging that eventually may complement or replace existing ones.

Summary

This dynamic evolution of MRD testing has complicated comparisons between individual studies. Nonetheless, an ever-growing body of data demonstrates that a positive MRD test at various time points throughout chemotherapy and hematopoietic cell transplantation identifies patients at particularly high risks of disease recurrence and short survival even after adjustment for other risk factors.

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Acknowledgements

R.B.W. is a Leukemia & Lymphoma Society Scholar in Clinical Research. This work was supported in part by the Intramural Research Program of the National Heart, Lung, and Blood Institute of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Biomedicine and Prevention, Hematology, University Tor Vergata, Via Montpellier 1, 00133, Rome, Italy

    Francesco Buccisano

  2. Myeloid Malignancies Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    Christopher S. Hourigan

  3. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Roland B. Walter

  4. Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA

    Roland B. Walter

  5. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Roland B. Walter

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  1. Francesco Buccisano
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Francesco Buccisano and Roland B. Walter each report no conflict of interest.

Christopher S. Hourigan receives research funding from Merck Sharp & Dohme and SELLAS Life Sciences Group AG.

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This article is part of the Topical Collection on Acute Myeloid Leukemias

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Buccisano, F., Hourigan, C.S. & Walter, R.B. The Prognostic Significance of Measurable (“Minimal”) Residual Disease in Acute Myeloid Leukemia. Curr Hematol Malig Rep 12, 547–556 (2017). https://doi.org/10.1007/s11899-017-0420-z

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