Monitoring: FACS

Question 1

Can NGS and MRD flowcytometry be used together?

Answer 1

The techniques are complimentary. Double positives have a very poor prognosis. Combining both techniques may lead to a more accurate risk assessment.

Question 2

What % of MRD (minimal residual disease cells) means a higher chance of relapse?

Answer 2

> 0.1% MRD (cells) means a higher chance of relapse. Prognostic relevance confirmed in clinical trials.

Question 3

Why is it important to look at clonal evolution when looking at relapse risk?

Answer 3

There can be shifts in population between diagnosis and relapse. A very small population at diagnosis can be the main population at relapse. This is how you can miss it. In most cases, it has an immature (stem cell like) phenotype. This small population can be found using a very sensitive method.

Question 4

Which two factors can point to patients with a high risk of relapse?

Answer 4

Patients with leukemic stem cells and minimal residual disease.