Abstract
The sensitive detection of minimal residual disease by the polymerase chain reaction (PCR) has revolutionized our ability to follow treatment response and predict relapse. Examples of how the detection of minimal residual disease can drive clinical research are best found in chronic myeloid leukemia (CML). The use of PCR to detect the BCR-ABL chimeric transcript in CML has been found to predict relapse in the transplant setting, and more recently, has been found in trials of imatinib to be a strong measure in predicting progression-free survival. In addition, clinical trials are now under way using the quantitative assessment of BCR-ABL as a surrogate outcome marker, potentially reducing the time and cost of clinical trials.
MeSH terms
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Adult
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Antineoplastic Agents / therapeutic use
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Benzamides
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Biomarkers, Tumor / blood*
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Bone Marrow Transplantation / methods
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Child
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Clinical Trials as Topic
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Combined Modality Therapy
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Disease-Free Survival
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Drug Monitoring
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Drug Resistance, Neoplasm / genetics
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Fusion Proteins, bcr-abl / antagonists & inhibitors
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Fusion Proteins, bcr-abl / blood*
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Fusion Proteins, bcr-abl / genetics
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Humans
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Imatinib Mesylate
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / blood
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology*
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery
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Multicenter Studies as Topic
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Neoplasm, Residual
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Piperazines / administration & dosage
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Piperazines / therapeutic use
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Polymerase Chain Reaction / methods*
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Protein Kinase Inhibitors / administration & dosage
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Protein Kinase Inhibitors / therapeutic use
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Pyrimidines / administration & dosage
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Pyrimidines / therapeutic use
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Recurrence
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Sensitivity and Specificity
Substances
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Antineoplastic Agents
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Benzamides
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Biomarkers, Tumor
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Piperazines
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Protein Kinase Inhibitors
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Pyrimidines
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Imatinib Mesylate
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Fusion Proteins, bcr-abl