By Pia Raanani, Andreas Hochhaus
Detection of minimum residual affliction (MRD) is more and more utilized in the administration of leukemia sufferers. a wide selection of equipment were built and contain applied sciences designed to realize residual malignant cells past the sensitivity of traditional methods equivalent to morphology and banding cytogenetics in leukemia. the alternative of the easiest technique is dependent upon the biology of the person malignancy, i.e. at the decision of particular markers that are beneficial to tell apart among leukemic cells and common hematopoiesis in leukemic sufferers. those markers comprise leukocyte differentiation antigens, fusion transcripts, transcripts overexpressed via mutated or nonmutated genes, rearranged genes, and person markers like polymorphic repetitive DNA sequences. the key applied sciences for MRD detection, their benefits and downsides and their scientific purposes are mentioned during this unique factor - from 'bench to bedside'.
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Extra info for Minimal Residual Disease In Hematologic Malignancies (Acta Haematologica 2004)
Nucleic Acid Amplification Techniques The most sensitive approach for detecting MRD involves nucleic acid amplification using the PCR. The PCR must have a specific genetic lesion as the ‘finger- Detection of Minimal Residual Disease in Acute Myelogenous Leukemia Acta Haematol 2004;112:40–54 41 print’ of the malignancy in order for PCR-driven reactions to have the desired sensitivity and specificity. Most commonly, the genetic target providing the ‘fingerprint’ is from the unique juxtaposition of genes occurring from chromosomal translocations .
Jude group defines MRD by FACS as the percentage of blasts among normal mononuclear cells while the Austrian group defines MRD as the absolute number of blasts per microliter [8, 19]. Until comparative multicenter standardized studies are published, IgTcR-PCR remains the benchmark, to which any method should be compared. Interestingly, independent studies using either FACS or IgTcR-PCR have reached similar conclusions (see below). It is quite possible, therefore, that because of their lower costs FACS and fusion mRNA detection will replace IgTcR-PCR in the future as the standard methodology for MRD detection.
3) The method should allow clear and precise quantification of MRD. (4) The leukemic-specific markers utilized for MRD detection should be stably expressed by the leukemic cell throughout the course of the disease. Since malignant cells are naturally genetically unstable, some potential markers present at the time of diagnosis may be lost later in the disease. A search for such an unstable marker later in the disease may lead, therefore, to false-negative result. (5) The technique should be easily reproducible within the same laboratory and between different laboratories.