Residual disease: the hematologist's point of view

Minimal residual disease (MRD) can be easily studied in hematological malig nancies by analyser of various fusion transcripts or tumor-specific immunog lobulin heavy-chain or T-cell receptor rearrangements as markers of disease . Correlation between MRD and prognosis has been extensively investigated m ostly in acute leukemia and chronic myeloid leukemia. Quantitative aspect s eems an essential criterion but the current absence of standardization make s difficult clinical decision according to MRD results. Development of real time quantitative PCR techniques would probably overcome these limitations . Only follicular non-Hodgkin's lymphomas are currently routinely analyzed using BCL2-J(H) PCR but signification of results obtained in complete remis sion remains uncertain. Analyses of tumor-specific immunoglobulin heavy-cha in or T-cell receptor rearrangements allow physiological study and evaluati on of bone marrow purgin system efficacy but are of limited interest in cur rent clinical practice.