Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia
Abstract Quantification of measurable residual disease (MRD) provides critical prognostic information in acute myeloid leukemia (AML). A variety of platforms exist for MRD detection, varying in their sensitivity and applicability to individual patients. MRD detected by quantitative polymerase chain...
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doaj-c67c87fda4294a258d5d00f818a07cc02021-09-05T11:13:38ZengBMCJournal of Hematology & Oncology1756-87222021-09-0114111510.1186/s13045-021-01148-5Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemiaMarisa J. L. Aitken0Farhad Ravandi1Keyur P. Patel2Nicholas J. Short3Department of Leukemia, The University of Texas MD Anderson Cancer CenterDepartment of Leukemia, The University of Texas MD Anderson Cancer CenterDepartment of Hematopathology, The University of Texas MD Anderson Cancer CenterDepartment of Leukemia, The University of Texas MD Anderson Cancer CenterAbstract Quantification of measurable residual disease (MRD) provides critical prognostic information in acute myeloid leukemia (AML). A variety of platforms exist for MRD detection, varying in their sensitivity and applicability to individual patients. MRD detected by quantitative polymerase chain reaction, multiparameter flow cytometry, or next-generation sequencing has prognostic implications in various subsets of AML and at various times throughout treatment. While it is overwhelmingly evident that minute levels of remnant disease confer increased risk of relapse and shortened survival, the therapeutic implications of MRD remain less clear. The use of MRD as a guide to selecting the most optimal post-remission therapy, including hematopoietic stem cell transplant or maintenance therapy with hypomethylating agents, small molecule inhibitors, or immunotherapy is an area of active investigation. In addition, whether there are sufficient data to use MRD negativity as a surrogate endpoint in clinical trial development is controversial. In this review, we will critically examine the methods used to detect MRD, its role as a prognostic biomarker, MRD-directed therapeutics, and its potential role as a study endpoint.https://doi.org/10.1186/s13045-021-01148-5Measurable residual diseaseAcute myeloid leukemiaSurrogate endpoint |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marisa J. L. Aitken Farhad Ravandi Keyur P. Patel Nicholas J. Short |
spellingShingle |
Marisa J. L. Aitken Farhad Ravandi Keyur P. Patel Nicholas J. Short Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia Journal of Hematology & Oncology Measurable residual disease Acute myeloid leukemia Surrogate endpoint |
author_facet |
Marisa J. L. Aitken Farhad Ravandi Keyur P. Patel Nicholas J. Short |
author_sort |
Marisa J. L. Aitken |
title |
Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
title_short |
Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
title_full |
Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
title_fullStr |
Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
title_full_unstemmed |
Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
title_sort |
prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia |
publisher |
BMC |
series |
Journal of Hematology & Oncology |
issn |
1756-8722 |
publishDate |
2021-09-01 |
description |
Abstract Quantification of measurable residual disease (MRD) provides critical prognostic information in acute myeloid leukemia (AML). A variety of platforms exist for MRD detection, varying in their sensitivity and applicability to individual patients. MRD detected by quantitative polymerase chain reaction, multiparameter flow cytometry, or next-generation sequencing has prognostic implications in various subsets of AML and at various times throughout treatment. While it is overwhelmingly evident that minute levels of remnant disease confer increased risk of relapse and shortened survival, the therapeutic implications of MRD remain less clear. The use of MRD as a guide to selecting the most optimal post-remission therapy, including hematopoietic stem cell transplant or maintenance therapy with hypomethylating agents, small molecule inhibitors, or immunotherapy is an area of active investigation. In addition, whether there are sufficient data to use MRD negativity as a surrogate endpoint in clinical trial development is controversial. In this review, we will critically examine the methods used to detect MRD, its role as a prognostic biomarker, MRD-directed therapeutics, and its potential role as a study endpoint. |
topic |
Measurable residual disease Acute myeloid leukemia Surrogate endpoint |
url |
https://doi.org/10.1186/s13045-021-01148-5 |
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