Comparison of Measurable Residual Disease in Pediatric B-Lymphoblastic Leukemia Using Multiparametric Flow Cytometry and Next-Generation Sequencing
2024; 44(4): 354-358
Ann Lab Med 2023; 43(4): 323-324
Published online February 24, 2023 https://doi.org/10.3343/alm.2023.43.4.323
Copyright © Korean Society for Laboratory Medicine.
Seon Young Kim , M.D., Ph.D.1 and Hee Jin Huh, M.D., Ph.D.2
1Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, Korea; 2Department of Laboratory Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
Correspondence to: Seon Young Kim, M.D., Ph.D.
Department of Laboratory Medicine, Chungnam National University College of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
Tel: +82-42-280-7894, Fax: +82-42-257-5365, E-mail: ksuny55@gmail.com
Hee Jin Huh, M.D., Ph.D.
Department of Laboratory Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 10326, Korea
Tel: +82-31-961-7893, Fax: +82-31-961-7902, E-mail: hjhuh@duih.org
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Measurable residual disease (MRD) is an important prognostic indicator of AML and is critical for risk stratification of treatment decisions [1]. Detecting MRD in patients with morphologically determined marrow with <5% blasts is important for refining the risk classification of AML [1, 2]. MRD detection in AML enables refined outcome prediction, impending relapse identification, and early intervention [1]. Several laboratory techniques can be utilized for the sensitive and accurate detection of MRD in AML and other hematologic malignancies. In clinical laboratories, molecular diagnostic methods, such as FISH and reverse transcription (RT)-PCR, have been used for the detection of recurrent fusion genes [3-4]. Newer diagnostic technologies, including droplet digital PCR (ddPCR), multiparametric flow cytometry, and next-generation sequencing (NGS), enable sensitive detection of MRD (up to 10-3–10-6 leukemic cell burden) [1, 4-6].
NGS is widely used in the diagnosis and risk stratification of AML [7, 8]. With improving methodology and decreasing costs, the application of NGS for detecting MRD in AML has become promising [4]. MRD monitoring in AML is more challenging given the heterogeneity of the disease with diverse genetic abnormalities, especially when recurrent gene fusions are absent, as against other acute leukemias with well-defined targets, such as immunoglobulin rearrangements in ALL [4]. Using NGS, targets encompassing fusion genes and recurrently mutated genes, such as
In their study in this issue, Kim,
The application of NGS technology in the diagnosis and risk stratification of AML is providing novel insights for clinical decisions. Further development and application of NGS technology to detect MRD in future studies and in clinical practice will highlight the usefulness of the test. While some challenges hinder the application and interpretation of the NGS MRD test, such as the presence of clonal hematopoiesis of indeterminate potential mutations, the data presented in this issue provide insights useful for clinical laboratory professionals and hematologists. We expect highly accurate and sensitive MRD detection methods to become widely available and actively used in clinical laboratories in the near future, thereby contributing significantly to improved patient outcomes.
Kim SY and Huh HJ contributed to writing the manuscript and approved the submission of the final manuscript.
The authors declare that they have no conflicts of interest.