Minimal Residual Disease in Acute Myeloid Leukemia

Date: March 20, 2014

Time: 11:00am EDT / 3:00pm GMT / 4:00pm CET (GMT+1) / 8:30pm IST (GMT+4.5) / 11:00pm  CST (GMT+8)

Join us for this live one-hour webinar with Q&A.

Presented by: Tarja-Terttu Pelliniemi, MD, PhD, Fimlab-Laboratories Ltd.

Moderator: Michael Kapinsky, Beckman Coulter


Minimal residual disease (MRD) refers to the proportion of leukemic cells present in morphologically defined complete remission. In acute lymphoblastic leukemia MRD is an independent prognostic marker and is currently included in therapeutic algorithms to guide post-induction treatments. During the past ten years several studies have shown that MRD is an important prognostic factor also in acute myeloid leukemia (AML) both in children, younger adults and elderly people. The preliminary results from Nordic Society of Pediatric Haematology and Oncology  (NOPHO) has confirmed the prognostic significance of MRD in AML. The current NOPHO-protocol (AML2013) includes MRD as early response criteria to identify the poor-risk patients, who might benefit from allogeneous stem cell transplantation.

MRD in AML can be based on molecular methods (PCR targeting fusion genes, mutations or expression levels of appropriate genes) or on multicolour flow cytometry. In flow cytometric MRD analysis leukemia-associated immunophenotypes (LAIPs) are indentified at diagnosis and applied to follow-up samples. Earlier, with four to six colour combinations, patient-specific LAIPs were designed on the basis of antigen profiles at diagnosis. Our strategy with eight to ten colour flow cytometry is to apply four standard combinations (for granulocytes, monocytes, stem cells and aberrant markers, respectively). This strategy not only allows the identification of LAIPs but also the analysis of granulocytic and monocytic differentiation patterns. The combinations also contain markers to identify e.g. mast cells, plasmacytoid dendritic cells, basophils and plasma cells, which may contaminate the so called blast area in CD45/side scatter plots. We in Tampere have three-year experience of ten-colour flow cytometric MRD analysis in adults with Navios instruments. In this webcast I will show examples of our patient data.

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