Journal of Blood Disorders & Transfusion

Minimal residual disease: Evolution of technology and clinical impact

4^th International Conference on Blood Malignancies & Treatment

April 18-19, 2016 Dubai, UAE

Azza M Kamel

Cairo University, Egypt

Posters & Accepted Abstracts: J Blood Disord Transfus

Abstract:

By definition, minimal residual disease (MRD) is the persistence of leukemic cells after chemotherapy at numbers below the sensitivity detection level of routine morphology. MRD is the strongest prognostic parameter, guides treatment decisions and can be used as a surrogate end point in clinical trials. Molecular based methods: In lymphoid malignancies, the concept of MRD detection relies on the fact that each case has a unique immune receptor gene rearrangement. The consensus primer PCR-based approach has low sensitivity (0.5-0.1%) and oligoclonality is a limiting factor. While the classical most widely used ASO-PCR method with 10-5-10-6 sensitivity is timeconsuming and labor intensive. In myeloid malignancies, Q-real-time PCR is used for cases with fusion gene rearrangements mainly in CML and M3. Flow cytometry-based methods: Flow cytometry MRD detection relies on the fact that leukemic cells do not obey the rules of normal differentiation. This forms the basis of leukemia-associated immunophenotype (LAIP). For ALL, it is the method of choice in most centers and used to make treatment decisions especially in pediatric ALL. For AML, an informative LAIP may not be recognized in a substantial number of cases and the approach of "different from normal pattern" or leukemia stem cell markers may be used for MRD detection. Flow cytometry is rapid and reliable but the sensitivity is questionable. High-throughput technologies: These were introduced to overcome the limitations of the time consuming labor intensive molecular techniques and the questionable sensitivity of standard flow cytometry. These are high throughput sequencing and multidimensional next-generation flow cytometry.

Biography :

Email: azzamkamel@yahoo.com