Bone marrow evaluation for diagnosis and monitoring of acute myeloid leukemia

Abstract

The diagnosis of acute myeloid leukemia (AML) can be made based on peripheral blood or bone marrow blasts. In this review, we will discuss the role of bone marrow evaluation and peripheral blood monitoring in the diagnosis, management, and follow up of AML patients. For patients with circulating blasts, it is reasonable to perform the necessary studies needed for diagnosis and risk stratification, including multiparametric flow cytometry, cytogenetics, and molecular analysis, on a peripheral blood specimen. The day 14 marrow is used to document hypocellularity in response to induction chemotherapy, but it is unclear if that assessmentis necessary as it often does not affect immediate management. Currently, response assessments performed at count recovery for evaluation of remission and measurable residual disease rely on bone marrow sampling. For monitoring of relapse, peripheral blood evaluation may be adequate, but the sensitivity of bone marrow testing is in some cases superior. While bone marrow evaluation can certainly be avoided in particular situations, this cumbersome and uncomfortable procedure currently remains the de facto standard for response assessment.

Technical Advances in the Measurement of Residual Disease in Acute Myeloid Leukemia

“…It is increasingly appreciated that MRD testing adds to prognostication in AML beyond established metrics such as patient age and cytogenetics [ 60 , 69 , 70 ]. Flow cytometry is the standard method for the measurement of residual disease in most subtypes of AML.…”

“…Mid-treatment biopsies may be performed, but they are of controversial utility. With the improvement of peripheral blood monitoring techniques, in combination with better imaging modalities, it may be possible to create a new standard for evaluating the response to treatment by minimizing the need for painful biopsies [ 60 ]. As a result of the cost and time needed to complete clinical trials, there are a lack of studies exploring imaging in AML.…”

A dual-signal amplification platform for sensitive fluorescence biosensing of leukemia-derived exosomes

“…Additionally, it is necessary to monitor the minimal residual disease (MRD) which is a critical factor in determining the prognosis of leukemia patients after treatment. 1 Diagnosis of leukemia is primarily performed on peripheral blood and bone marrow, which relies upon a multiparametric approach involving a number of different pathology disciplines. Various conventional and modern molecular technologies are being increasingly employed to help refine diagnosis.…”

KD025, an anti‑adipocyte differentiation drug, enhances the efficacy of conventional chemotherapeutic drugs in ABCG2‑overexpressing leukemia cells

“…The present study was approved by the Ethics Review Committee of Sun Yat-Sen University. Bone marrow blood (3 ml) was obtained from nine patients diagnosed with AML or acute lymphoblastic leukemia (ALL) according to FAB classification (24). All patients provided written informed consent.…”