Description:
The ability to detect residual levels of leukemic blasts (measurable residual disease, MRD)has already been integrated in the daily routine for treatment of patients with chronic myeloid andacute lymphoblastic leukemia. In acute myeloid leukemia (AML), a variety of mostly retrospectivestudies have shown that individuals in AML remission who tested positive for MRD at specifictime-points or had increasing MRD levels are at significantly higher risk of relapse and deathcompared to MRD-negative patients. However, these studies differ with respect to the “MRD-target”,time-point of MRD determination, material analyzed, and method applied. How this probablyvery valuable MRD information in individual patients may be adapted in the daily clinical routine,e.g., to separate patients who need more aggressive therapies from those who may be sparedadditional—potentially toxic—therapies is still a work-in-progress. With the exception of MRDassessment in acute promyelocytic leukemia (APL), the lack of randomized, prospective trials rendersMRD-based decisions and clinical implications in AML a difficult task. As of today, we still donot have proof that early intervention in MRD-positive AML patients would improve outcomes,although this is very likely. In this article, we review the current knowledge on non-APL AML MRDassessment and possible clinical consequences.