The clinical significance of minimal residual disease detecting in patient with acute myeloid leukemia

Objective To investigate the clinical significance of minimal residual disease(MRD) detection in patient with acute myeloid leukemia used for predicting relapse and guiding chemotherapy.Methods 128 Bone marrow aspirate were collected from 32 patients with newly diagnosed AML(exclude M3).Selecting 2 -4 antibodies combination,MRD was detected by four-color multiparameter flowcytometry(FCM) with CD45/SSC gating from the 21th days after induction treatment,and was done once more every one or three months.Results The MRD of the 32 cases in the 21th day after induction treatment were devided into three groups.high group(MRD1×10-2)、moderate group(MRD between 1×10-2 and 1×10-4) and low group(MRD1×10-4).The proportion of relapse about three groups in two years was 83.3%、11.1%、0.The proportion of relapse was the highest of three group when MRD 1×10-2.Patients with a level of MRD10-4 had good prognosis.There was statistical significance between high group and low group(P0.05).The result about the traditional bone marrow cells morphology and continuously monitoring of MRD showed that twenty-six patients were CR and the other six patients were continuing positive and relapsed after 4-6 months.There was statistical significance about the proportion of relapse between groups of MRD positive and negative(P0.05).Conclusion The risk of relapse was higher when MRD1×10-2.The result showed that MRD detection can predict relapse earlier than the traditional bone marrow cells morphology.So it has an important clinical significance to predict relapse and guide the individualized chemotherapy with continuous monitoring of MRD.