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Strategies for minimal residual disease detection: current perspectives

機(jī)譯：最小殘留疾病檢測(cè)的策略：當(dāng)前觀點(diǎn)

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Currently, the post-remission treatment in acute leukemia is based on the genetic profile of leukemic cells at diagnosis (ie, ITD positivity) and on the level of measurable residual disease (MRD) after induction and consolidation chemotherapy. Two methods are currently preferred for MRD evaluation in many centers: multiparameter flow cytometry and real-time quantitative PCR. Additional methods such as next-generation sequencing and digital PCR are under investigation, in an attempt to increase the sensitivity and thus allowing the detection of small clones. Many studies suggest that MRD positivity after chemotherapy is associated with negative prognosis, and the reappearance of MRD during follow-up allows impending relapse to be identified and consequently enables early intervention. Finally, MRD positivity before hematopoietic stem cell transplantation is predictive of the outcome. Although the significance of MRD in acute leukemia has been widely explored, the assessment of molecular MRD is not yet a routine practice. In this review, we describe the significance of MRD in different settings and the main markers and methods used for MRD detection.
機(jī)譯：當(dāng)前，急性白血病的緩解后治療基于診斷時(shí)白血病細(xì)胞的遺傳特征（即ITD陽(yáng)性）以及誘導(dǎo)和鞏固化療后可測(cè)量的殘留疾?。∕RD）的水平。目前，在許多中心，兩種方法優(yōu)選用于MRD評(píng)估：多參數(shù)流式細(xì)胞術(shù)和實(shí)時(shí)定量PCR。正在研究其他方法，例如下一代測(cè)序和數(shù)字PCR，以嘗試提高靈敏度，從而檢測(cè)小克隆。許多研究表明，化療后MRD陽(yáng)性與陰性預(yù)后相關(guān)，并且在隨訪期間MRD的重新出現(xiàn)可以確定即將發(fā)生的復(fù)發(fā)，因此可以進(jìn)行早期干預(yù)。最后，造血干細(xì)胞移植之前的MRD陽(yáng)性可預(yù)示結(jié)果。盡管人們已經(jīng)廣泛探索了MRD在急性白血病中的重要性，但是對(duì)分子MRD的評(píng)估還不是常規(guī)方法。在這篇綜述中，我們描述了MRD在不同環(huán)境中的重要性以及用于MRD檢測(cè)的主要標(biāo)志物和方法。

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