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ARTICLE
Year : 2011  |  Volume : 2  |  Issue : 4  |  Page : 306-311

Minimal residual disease testing in Acute Leukemia


Assistant Professor of Pathology and Immunology, Director FISH laboratory in Anatomic Pathology, Washington University in St Louis , School of Medicine, St Louis, Missouri, USA

Correspondence Address:
MD Anjum Hassan
Assistant Professor of Pathology and Immunology, Director FISH laboratory in Anatomic Pathology, Washington University in St Louis , School of Medicine, St Louis, Missouri
USA
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Source of Support: None, Conflict of Interest: None


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Acute leukemia (AL) is a complex disease with considerable phenotypic and morphologic heterogeneity. The phenotype is often assessed by multiparameter flow cytometry ideally on aspirated bone marrow. These leukemia associated phenotypes (LAPs) are crucial for disease monitoring. In addition, there are more than 100 recurring cytogenetic abnormalities encountered in acute myeloid leukemia (AML) and similarly, multiple acquired genetic abnormalities are responsible for aberrant proliferation and differentiation arrest seen in acute lymphoblastic leukemia (ALL). WHO requires a combination of both immunophenotypic and cytogenetic studies to definitively classify AL. Outgrowth of minimal residual disease (MRD) in AL is responsible for the occurrence of relapses. These are cells present in the bone marrow after treatment and these can be monitored by molecular, biologic and or immunophenotypic detection methods. Defining MRD is thought to be crucial in defining patient-tailored post remission therapy which might reduce the risk of relapse or diminish morbidity and mortality in AL. This may also allow detection of impending relapses for early intervention. Immunophenotyping by flow cytometry (FC) is a cost effective and fast tool for detection of MRD. Essentially all cases of AL possess a unique phenotype with multiple aberrancies which tend to remain stable during the course of relapses. By defining these LAPs on malignant cells at diagnosis, flow cytometry can be highly reliable in MRD parameter assessment at different stages AL, consequently predicting survival and forthcoming relapses.


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