Application of the polymerase chain reaction to detection of minimal residual disease

Abstract

The exquisite sensitivity of the polymerase chain reaction makes it potentially possible to detect a small population of neoplastic cells provided that they contain DNA or RNA which differs from the nonneoplastic population. For haemopoietic cells, this situation obtains for translocations, for the rearranged immunoglobulin and T-cell receptor genes of B or T disorders, for mutated oncogenes such as <i>ras</i>, and for repetitive segments of DNA. In this presentation the technical aspects of detection of minimal residual disease will be discussed using examples from the above areas. The clinical value of detection of minimal residual disease is a separate issue which will be resolved over the next few years. However, it does seem likely that important information on the biology, treatment and prognosis of haematological neoplasms will be obtained.