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The detection of minimal residual disease: implications for bone marrow transplantation

  • Chapter
Blood Stem Cell Transplantation

Part of the book series: Cancer Treatment and Research ((CTAR,volume 77))

Abstract

The source of relapse in patients who achieve complete clinical remission is residual cancer cells that number below the limits of detection using standard diagnostic techniques. Therefore, considerable effort has been made over the past decade to develop new techniques that have greatly increased the sensitivity of detection of small numbers of residual neoplastic cells. In particular, the identification of specific gene rearrangements and chromosomal translocations in neoplastic cells has permitted the development of sensitive molecular techniques that are capable of detecting minimal residual disease. With the development of these more sensitive techniques, especially by the application of PCR technology, the presence of residual neoplastic cells in patients in complete clinical remission, commonly called minimal residual disease (MRD), has been demonstrated clearly. It seems obvious to patients that if residual cancer cells can still be detected, then additional therapy is necessary for cure; nevertheless, the data demonstrating that detection of MRD using PCR-based techniques is associated with increased risk of relapse has been difficult to establish. In certain disease states, such as chronic myelogenous leukemia, there are now sufficient data demonstrating that detection of MRD is associated with a poor enough prognosis to merit experimental treatment approaches on the basis of detection of disease by PCR techniques alone. If this can be established in other malignancies, then molecular biologic techniques will become an essential part of staging and follow-up of patients and will redefine our concept of complete remission.

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Authors
  1. John G. Gribben
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  2. Joachim L. Schultze
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Editors and Affiliations

  1. Bone Marrow Transplant Program, Robert H. Lurie Cancer Center, Northwestern Memorial Hospital and Northwestern University, Chicago, Illinois, 60611, USA

    Jane N. Winter M.D.

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Gribben, J.G., Schultze, J.L. (1997). The detection of minimal residual disease: implications for bone marrow transplantation. In: Winter, J.N. (eds) Blood Stem Cell Transplantation. Cancer Treatment and Research, vol 77. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6349-5_5

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  • DOI: https://doi.org/10.1007/978-1-4615-6349-5_5

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