In the context of precision medicine, assessment of minimal residual disease (MRD) has been used in acute myeloid leukemia (AML) to direct individual treatment programs, including allogeneic stem cell transplantation in patients at high-risk of relapse. One of the limits of this approach has been in the past the paucity of AML markers suitable for MRD assessment. Recently, the number of biomarkers has increased, due to the identification of highly specific leukemia-associated immunophenotypes by multicolor flow-cytometry, and of rare mutated gene sequences by digital droplet PCR, or next-generation sequencing (NGS). In addition, NGS allowed unraveling of clonal heterogeneity, present in AML at initial diagnosis or developing during treatment, which influences reliability of specific biomarkers, that may be unstable during the disease course. The technological advances have increased the application of MRD-based strategies to a significantly higher number of AML patients, and the information deriving from MRD assessment has been used to design individual post-remission protocols and pre-emptive treatments in patients with sub-clinical relapse. This led to the definition of MRD-negative complete remission as outcome definition in the recently published European Leukemianet MRD guidelines. In this review, we summarized the principles of modern technologies and their clinical applications for MRD detection in AML patients, according to the specific leukemic markers.

Voso, M.t., Ottone, T., Lavorgna, S., Venditti, A., Maurillo, L., Lo-Coco, F., et al. (2019). MRD in AML: The Role of New Techniques. FRONTIERS IN ONCOLOGY, 9, 655 [10.3389/fonc.2019.00655].

MRD in AML: The Role of New Techniques

Voso M. T.;Ottone T.;Lavorgna S.;Venditti A.;Lo-Coco F.;Buccisano F.
2019-01-01

Abstract

In the context of precision medicine, assessment of minimal residual disease (MRD) has been used in acute myeloid leukemia (AML) to direct individual treatment programs, including allogeneic stem cell transplantation in patients at high-risk of relapse. One of the limits of this approach has been in the past the paucity of AML markers suitable for MRD assessment. Recently, the number of biomarkers has increased, due to the identification of highly specific leukemia-associated immunophenotypes by multicolor flow-cytometry, and of rare mutated gene sequences by digital droplet PCR, or next-generation sequencing (NGS). In addition, NGS allowed unraveling of clonal heterogeneity, present in AML at initial diagnosis or developing during treatment, which influences reliability of specific biomarkers, that may be unstable during the disease course. The technological advances have increased the application of MRD-based strategies to a significantly higher number of AML patients, and the information deriving from MRD assessment has been used to design individual post-remission protocols and pre-emptive treatments in patients with sub-clinical relapse. This led to the definition of MRD-negative complete remission as outcome definition in the recently published European Leukemianet MRD guidelines. In this review, we summarized the principles of modern technologies and their clinical applications for MRD detection in AML patients, according to the specific leukemic markers.
2019
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/15 - MALATTIE DEL SANGUE
English
AML; MRD; NGS; digital droplet PCR; multiparametric flow-cytometry
Voso, M.t., Ottone, T., Lavorgna, S., Venditti, A., Maurillo, L., Lo-Coco, F., et al. (2019). MRD in AML: The Role of New Techniques. FRONTIERS IN ONCOLOGY, 9, 655 [10.3389/fonc.2019.00655].
Voso, Mt; Ottone, T; Lavorgna, S; Venditti, A; Maurillo, L; Lo-Coco, F; Buccisano, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/220059
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