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Review Articles
NUMBER 3-4 YEAR 2011
Minimal Residual Disease - Generalities and Perspectives
1 Regional Center for Transplant Immunology, Emergency Clinical County Hospital Timisoara,
2 Victor Babes University of Medicine and Pharmacy, Timisoara

Correspondence to:
Florina Boldeanu, Regional Center for Transplant Immunology, Emergency Clinical County Hospital,
10 Iosif Bulbuca Blvd., 300736 Timisoara
Email: boldeanu.florina@yahoo.com
REZUMAT
Boala minima reziduala (Minimal Residual Disease - MRD) reprezinta numarul mic de celule tumorale leucemice care ramân in pacient in timpul tratamentului sau dupa aceea, atunci când acesta este in remisie (fara simptome sau semne de boala). Daca, dupa aproximativ patru saptamâni de chimioterapie, exista mai putin de 5% celule-blast intr-un esantion de maduva osoasa, pacientul este in remisie clinica. Trei metode sunt disponibile pentru monitorizarea MRD: flux-citometrie immunofenotipica folosind etichetarea dubla sau tripla pentru a detecta immunofenotipurile specifice leucemiei; analiza de tip reactia in lant a polimerazei (polymerase chain reaction (PCR)), a intreruperilor din regiunile de fuziune ale aberatiilor cromozomiale specifice leucemiei; analiza de tip PCR a regiunilor jonctionale de rearanjamente imunoglobuline (Ig) si receptorilor celulelor T (TCR). Detectia MRD asigura oportunitati unice pentru interventia terapeutica atunci când nici unul sau câtiva blasti sunt rezistenti la medicamente, in timp ce analiza MRD are câteva roluri importante: sa determine daca tratamentul cancerului indeparteaza urmele ramase; comparând eficienta diferitelor tratamente; monitorizarea statusului pacientului, remisia si recurenta leucemiei; sau personalizarea tratamentului cancerului.

ABSTRACT
Minimal residual disease (MRD) is the small number of leukemic tumor cells that remain in the patient during treatment or afterwards, when the patient is in remission (no symptoms or signs of disease). If there are less than 5% blasts in a bone marrow sample, the patient is in clinical remission (CR) after about four weeks of chemotherapy. Three methods are available for MRD monitoring: flow-cytometric immunophenotyping using double or triple labeling to detect leukemia-specific immunophenotypes; polymerase chain reaction (PCR) analysis of breakpoint fusion regions of leukemia-specific chromosome aberations; PCR analysis of the clone-specific junctional regions of immunoglobulin (Ig) and T-cell receptor (TCR) rearrangements. MRD detection provides unique opportunities for therapeutic intervention when none or few blasts are resistant to drugs, while MRD analysis has several important roles: to determine if treatment cancer removes remaining traces; comparing the efficacy of different treatments; monitoring patient status, remission and recurrence of leukemia; or personalizition of the cancer treatment.


"Victor Babes" Publishing House "Victor Babes" University of Medicine and Pharmacy Romanian Academy of Medical Sciences National Council of Scientific Research in Higher Education (B+) Index Copernicus
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