DETECTION OF MINIMAL RESIDUAL DISEASE IN ACUTE MYELOGENOUS LEUKEMIA

Techniques to assay minimal residual disease are available for most pa tients with acute lymphoblastic leukemia, non-Hodgkin's lymphoma, brea st cancer, Ewing's sarcoma, and others. Today, a few such tests exist for acute myelogenous leukemia (AML). This review evaluates the tests available for assessing minimal residual disease in AML: morphology, g rowth in vitro, cytogenetics, magnetic resonance imaging, polymerase c hain reaction (PCR)-based assays for translocation products, and multi parameter flow cytometry. Of these, multiparameter flow cytometry appe ars most promising. Studies using multiparameter flow cytometry to ide ntify leukemic cells by aberrant antigen expression have reported a hi gh positive predictive value with regard to the incidence of relapse. In addition, the test is specific, rapid, inexpensive, and applicable to a sufficiently broad group of patients, allowing its use outside of the research laboratory setting. Judicious use of some of the availab le assays singly or in combination should identify patients harboring residual leukemic cells.