Flow cytometry and polymerase chain reaction-based analyses of minimal residual disease in chronic lymphocytic leukemia.

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BlankFlow cytometry and polymerase chain reaction-based analyses of minimal

residual disease in chronic lymphocytic leukemia.

S Uhrmacher, F Erdfelder, and KA Kreuzer

Adv Hematol, January 1, 2010; 2010:

Department I of Internal Medicine, University at Cologne, Kerpener Stra?e 62,

50937 Cologne, Germany.

New therapeutic strategies developed recently for chronic lymphocytic leukemia

(CLL) have led to remarkable treatment response rates and complete hematological

remissions. This means highly sensitive and specific techniques are increasingly

needed to evaluate minimal residual disease (MRD) in CLL patients. Quantitative

MRD levels can be used as prognostic markers, where total MRD eradication is

associated with prolonged survival. Nowadays, PCR and flow cytometry techniques

used to detect MRD in CLL patients can generate reliable and quantitative

results with the highest sensitivity. MRD Flow is based on four-color flow

cytometry using specific antibody combinations. For allele specific

oligonucleotide real-time quantification (ASO RQ) PCR individual primers are

designed to detect a specific immunoglobulin heavy chain (IgH) rearrangement in

each patient clone. Five comprehensive studies investigated and compared the

sensitivity and specificity of both methods. Groups of patients receiving

different therapies were analyzed at different time points to generate

quantitative MRD levels and MRD kinetics. All studies confirmed that both

methods generate equivalent results with regard to sensitivity and MRD

quantification, although each method has advantages and disadvantages in the

daily routine of a standard hematological laboratory. Here, we review these

investigations and compare their results in the light of modern therapies.

PMID: 20886004