Minimal residual disease in acute leukemia based on the insight of molecular genetics monitoring

Abstract

Patients with acute leukemia port 10 malignant cells at presentation. Following chemotherapy or stem cell transplant, patients in complete remission by conventional analyses may still harbor 106/108 malignant cells below the detection limit of standard clinical assessment. Minimal residual disease (MRD) monitoring is one of the most powerful predictors of disease-free and overall survival, particularly for children with acute lymphoblastic leukemia (cALL), the percent annual of cALL increase in the incidence of cALL in Saudi Arabia. Breakpoint fusion regions of chromosomal aberrations can be used as tumor-specific targets for MRD detection by polymerase chain reaction. Levels of MRD, measured at critical time points, significantly correlate with clinical outcomes. Previous works investigated the prognostic significance of leukemia-associated immunophenotypes (LAIPs) as an assessment of the index of MRD in 125 adult B-ALL patients by eight-colour flow cytometry. More advanced molecular and genetics studies are so necessary to identify the mechanisms and cellular structure of the minimal-level disease. Selecting molecular methods for minimal residual disease detection have a much higher sensitivity and precision (100-fold or more) than others. This review highlights the minimal residual disease molecular detection to demonstrate the characterization of the lymphoblastic leukemia gene. Precise MRD monitoring predicts disease relapse after chemotherapy or SCT, provides early intervention, and may result in the rescue of many patients and improvement in the probability of long-term disease-free survival.