Detection of minimal residual disease

Abstract

Minimal residual disease (MRD) is defined as the presence of a small number of cancer cells in hematological malignancies usually below 10 10 cells (that amount approximately corresponds to 1g of the total cancer cell burden in a human body). The ability to distinguish residual malignant cells among a normal population of cells is inherently dependent on the presence of identifiable cellular or subcellular features specific to the malignant clone. Unique combinations of surface, cytoplasmic, or nuclear molecules that are expressed by the malignant clone and are not present in normal cell population allow multiparameter flow-cytometric detection of MRD. This chapter presents an overview of the most current technology used for defining the advancement in MRD. It also focuses on MRD in acute and chronic leukemias and some lymphoproliferative disorders. In both acute and chronic leukemias and also in multiple myeloma, bone marrow (BM) is the primary and most significant compartment for MRD analysis.