Proposal as to which platforms are now ready for “prime time” according to AML disease subtype and clinical context
| Platform . | Timing of MRD assessment . | Applicability . | Comments . | |
|---|---|---|---|---|
| Early risk stratification . | Sequential MRD monitoring (longitudinal postconsolidation) . | |||
| Flow cytometry | * | † | >90% | Ready to be used for assessing CR status |
| MRD analysis needs to be conducted in expert laboratories with standardization | ||||
| RT-qPCR | ||||
| Fusion genes/NPM1 mutation | Marker-dependent | * | 32-62%‡ | Standardized assays for leukemia-specific targets available and widely validated |
| WT1 expression | § | † | ∼45% | Assays insensitive and not leukemia-specific, but can predict outcome |
| Next-generation sequencing | † | † | To be established | Promising preliminary data |
| Digital PCR | † | † | To be established | Potentially applicable to detect mutations and fusion genes |
| Platform . | Timing of MRD assessment . | Applicability . | Comments . | |
|---|---|---|---|---|
| Early risk stratification . | Sequential MRD monitoring (longitudinal postconsolidation) . | |||
| Flow cytometry | * | † | >90% | Ready to be used for assessing CR status |
| MRD analysis needs to be conducted in expert laboratories with standardization | ||||
| RT-qPCR | ||||
| Fusion genes/NPM1 mutation | Marker-dependent | * | 32-62%‡ | Standardized assays for leukemia-specific targets available and widely validated |
| WT1 expression | § | † | ∼45% | Assays insensitive and not leukemia-specific, but can predict outcome |
| Next-generation sequencing | † | † | To be established | Promising preliminary data |
| Digital PCR | † | † | To be established | Potentially applicable to detect mutations and fusion genes |
Validated in large studies within clinical trials.
Investigational.
Proportion of AML cases informative for a leukemia-specific molecular marker suitable for detection by RT-qPCR (ie, fusion gene, NPM1 mutation) varies according to age (see Figure 3).
Some supportive data, but not ready for “prime time.”