Relapse of leukemia following successful remission-induction therapy
remains a major obstacle in the treatment of patients with acute
leukemia. Leukemia recurs most frequently in patients with acute
myeloblastic leukemia (AML) and high risk acute lymphoblastic leukemia
(ALL) following chemotherapy and less often in patients with low risk
ALL and particularly in patient groups> submitted to allogeneic marrow
transplantation. ' It is likely that the great majority of these
recurrences originate from residual leukemic cells that survive initial
remission-induction chemotherapy. Today, several research groups
throughout the world place emphasis on studies concerned with the
detection and treatment of 'minimal residual disease' (MRD). These
investigations are conducted with the common objective to tackle the
remaining cells. 'Minimal Residual Disease in Acute Leukemia: 1986'
summarizes the fast advancements in this area. Several disciplines are
concerned with the analysis of leukemic cells. The perspectives of
cytogenetic and molecular genetic approaches for applica- tion in the
detection of MRD are reviewed. In this respect, modern cyto- genetics
provide highly specific tumor markers. The resolution of cyto- genetic
methods can be particularly improved when combined with other techniques
which select relevant subpopulations of cells. Characterization of
oncogenes and gene rearrangements, including those of immunoglobulin and
T-cell receptor genes, and the measurement of gene products, have been
established. Techniques based on these approaches offer interesting
tools for the detection of MRD. New possibilities of employing
monoclonal anti- bodies are also presented.
