Assessing minimal residual disease in chronic lymphocytic leukemia.

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BlankAssessing minimal residual disease in chronic lymphocytic leukemia.

AC Rawstron and P Hillmen

Curr Hematol Malig Rep, January 1, 2008; 3(1): 47-53.

Haematological Malignancy Diagnostic Service, Leeds Teaching Hospitals, Leeds,

UK. Andy.Rawstron@...

New treatment approaches have substantially improved response rates in chronic

lymphocytic leukemia. Accurate assessment of effective combination

chemoimmunotherapy requires more sensitive measures of response, and a variety

of techniques to measure minimal residual disease (MRD) have been developed.

Because many studies demonstrate that MRD eradication is associated with

prolonged treatment-free survival, detection of MRD is becoming a standard

component of clinical trials. Quantitative approaches using polymerase chain

reaction or multiparameter flow cytometry are preferable because they allow

comparison of efficacy between different studies. In most clinical settings, the

levels of chronic lymphocytic leukemia always increase from the first detection

of MRD; the exception is allogeneic transplantation, in which there may be

stable MRD levels or delayed MRD eradication. MRD analysis in the peripheral

blood also may be used during therapy to predict eventual response and

potentially to guide therapy to achieve the optimal outcome.

PMID: 20425446