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J. Clin. Med. 2017, 6(6), 57; doi:10.3390/jcm6060057

Minimal Residual Disease in Acute Myeloid Leukemia: Still a Work in Progress?

1
Hematology and Bone Marrow Transplantation Unit, Ospedale Centrale “San Maurizio”, Azienda Sanitaria dell’Alto Adige, via L. Bohler 5, 39100 Bolzano, Italy
2
Hematology, Ospedali Riuniti di Ancona, 60121 Ancona, Italy
3
Hematology, Ospedale “Ca’ Foncello”, AULSS 2, 31100 Treviso, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Marco Ladetto
Received: 8 May 2017 / Revised: 30 May 2017 / Accepted: 31 May 2017 / Published: 3 June 2017
(This article belongs to the Special Issue Role of Minimal Residual Disease Assessment in Hematological Cancers)
View Full-Text   |   Download PDF [585 KB, uploaded 21 June 2017]   |  

Abstract

Minimal residual disease evaluation refers to a series of molecular and immunophenotypical techniques aimed at detecting submicroscopic disease after therapy. As such, its application in acute myeloid leukemia has greatly increased our ability to quantify treatment response, and to determine the chemosensitivity of the disease, as the final product of the drug schedule, dose intensity, biodistribution, and the pharmakogenetic profile of the patient. There is now consistent evidence for the prognostic power of minimal residual disease evaluation in acute myeloid leukemia, which is complementary to the baseline prognostic assessment of the disease. The focus for its use is therefore shifting to individualize treatment based on a deeper evaluation of chemosensitivity and residual tumor burden. In this review, we will summarize the results of the major clinical studies evaluating minimal residual disease in acute myeloid leukemia in adults in recent years and address the technical and practical issues still hampering the spread of these techniques outside controlled clinical trials. We will also briefly speculate on future developments and offer our point of view, and a word of caution, on the present use of minimal residual disease measurements in “real-life” practice. Still, as final standardization and diffusion of the methods are sorted out, we believe that minimal residual disease will soon become the new standard for evaluating response in the treatment of acute myeloid leukemia. View Full-Text
Keywords: acute myeloid leukemia; minimal residual disease; allogeneic transplantation; leukemia-initiating cells; leukemia stem cells; next generation sequencing; multiparameter flow cytometry acute myeloid leukemia; minimal residual disease; allogeneic transplantation; leukemia-initiating cells; leukemia stem cells; next generation sequencing; multiparameter flow cytometry
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Mosna, F.; Capelli, D.; Gottardi, M. Minimal Residual Disease in Acute Myeloid Leukemia: Still a Work in Progress? J. Clin. Med. 2017, 6, 57.

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