MRD technologies and clinical applications – Flow, qPCR, dPCR, NGS
MRD assessment by multicolor flow-cytometry (MFC-MRD)
Immunophenotyping is an essential, readily available tool for diagnosing AML and is currently the most commonly used MRD detection methodology. Two separate approaches have been used for assessing MFC MRD: The LAIP approach, which defines leukemia-associated immunophenotypes (LAIPs) at diagnosis and tracks these in subsequent samples; and the different-from-normal (DfN) approach, which is based on the identification of aberrant differentiation/maturation profiles at follow-up. Technical recommendations on the use of MFC-MRD in AML are detailed here.
Molecular MRD
There are two general approaches to molecular MRD assessment: PCR and next generation sequencing (NGS). Techniques for molecular MRD assessment include quantitative polymerase chain reaction (qPCR), digital PCR (dPCR), or error corrected NGS with unique molecular identifiers (UMIs). Updated recommendations are summarized here.