The role of minimal disease testing in acute myeloid leukemia (AML) has been explored for many years. Based on the clear association with outcomes, measurable residual disease (MRD) has been incorporated into the consensus guidelines to reflect complete remission without MRD as an official AML response criterion. There are different methods for assessing MRD, including next-generation sequencing, polymerase chain reaction, and multicolor flow cytometry, all with varying levels of sensitivity. Multicolor flow cytometry is the more commonly used method in the US. However, the sensitivity of the multicolor flow cytometry assay can be dependent on the quality of the sample collected during bone marrow biopsy and on the experience of the laboratory; the latter is important in distinguishing the immunophenotype of the AML clone vs hematogone, which has traditionally been more difficult to distinguish in AML than in acute lymphoblastic leukemia.
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Jeyakumar D, O’Brien S. Minimal Residual Disease in Acute Myeloid Leukemia. JAMA Oncol. 2020;6(12):1899–1900. doi:10.1001/jamaoncol.2020.4599
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