Vol 9, No 2 (2018)
Review paper
Published online: 2018-08-17
Significance of minimal residual disease assessment in patients with chronic lymphocytic leukemia
Hematologia 2018;9(2):123-132.
Abstract
Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder of mature B lymphocytes characterized by a heterogenous clinical course. Approximately 60% of cases require treatment initiation due to disease advancement. Immunochemotherapy enables achievement of durable remissions in some of the patients, however despite the observed complete responses relapses occur. These are explained by the persistence of residual leukemic cells in blood, bone marrow and lymph nodes, defined as minimal residual disease (MRD). Use of flow cytometry and molecular methods in assessment of treatment response allows for more detailed response quantification and detection of leukemic cells with ≥ 10-5 sensitivity. Elimination of MRD is an important prognosticator of durable remissions following immunochemotherapy. Furthermore, the significance of MRD assessment increases due to its possible role in CLL treatment individualization and potential surrogate marker of response without the need of long lasting observations. Herein in this publication, the clinical significance of MRD assessment emphasizing flow cytometric methodology is summarized.
Keywords: chronic lymphocytic leukemiadiagnosticsminimal residual diseaseimmunochemotherapyflow cytometry
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