Skip to main content Skip to main navigation menu Skip to site footer

Peranan klinis Measurable Residual Disease (MRD) sebagai faktor prognostik dan optimalisasi terapi pada Leukemia Myeloid Akut (LMA): sebuah tinjauan pustaka

Abstract

Background: Acute Myeloid Leukemia (AML) is the most common type of blood cancer and accounts for 80% of cases in the adult population. The condition of relapse in AML occurs due to residual cells in the spinal cord after chemotherapy, defined as Measurable Residual Disease (MRD). This literature review aims to determine the clinical role of MRD as a prognostic factor and optimization of therapy in AML.

Methods: This literature review was carried out by searching studies on online databases in the form of PubMed, Cochrane library, and Google Scholar using the keywords "acute myeloid leukemia", "measurable residual disease", "prognostic", "clinical outcome", and "clinical implication". Appropriate studies then carried out a narrative synthesis analysis.

Results: There are some MRD examination methods, including karyotyping, fluorescence in situ hybridization (FISH), multiparameter flow cytometry (MFC), reverse transcription-quantitative Polymerase Chain Reaction (RT-qPCR), and Next-Generation Sequencing (NGS). Positive MRD status is associated with higher recurrence rates and lower overall survival and disease-free survival than LMA patients with negative MRD status.

Conclusion: Measurable Residual Disease (MRD) is an examination that has a significant relationship with the clinical outcome of ALM patients and has therapeutic implications for the determination of consolidation therapy in the form of hematopoietic stem cell transplantation.

 

Latar Belakang: Leukemia Myeloid Akut (LMA) merupakan jenis kanker darah yang paling umum ditemui dan menyumbang sebanyak 80% kasus pada populasi dewasa. Kondisi relapse pada LMA terjadi akibat adanya sisa sel pada sumsum tulang belakang pasca kemoterapi yang didefinisikan sebagai Measurable Residual Disease (MRD). Tinjauan pustaka ini bertujuan untuk mengetahui peranan klinis MRD sebagai faktor prognostik dan optimalisasi terapi pada LMA.

Metode: Tinjauan pustaka ini dilakukan dengan pencarian studi pada basis data online berupa PubMed, Cochrane library, dan Google Scholar dengan menggunakan kata kunci “acute myeloid leukemia”, “measurable residual disease”, “prognostic”, “clinical outcome”, dan “clinical implication”. Studi yang sesuai kemudian dilakukan analisis sintesis secara naratif.

Hasil: Terdapat sejumlah metode pemeriksaan MRD diantaranya kariotiping, fluorescence in situ hybridization (FISH), multiparameter flow cytometry (MFC), reverse transcription-quantitative polymerase chain reaction (RT-qPCR), dan next generation sequencing (NGS). Status MRD positif diketahui berhubungan dengan angka kekambuhan yang tinggi dan kesintasan keseluruhan serta kelangsungan hidup bebas penyakit yang lebih rendah dibandingkan pasien LMA dengan status MRD negatif.

Simpulan: Measurable Residual Disease (MRD) merupakan pemeriksaan yang memiliki hubungan signifikan dengan luaran klinis pasien LMA dan memiliki implikasi terapeutik untuk penentuan dilakukannya terapi konsolidasi berupa transplantasi sel punca hematopoietik.

References

  1. Döhner H, Weisdorf DJ, Bloomfield CD. Acute myeloid leukemia. New England Journal of Medicine. 2015; 373(12):1136-1152.
  2. Parmawati NKA, Herawati S, Wande IN. Myelodysplastic Syndrome (MDS) in a Child who Transformed to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC). Bali Medical Journal. 2019;8(2):358-362.
  3. Prabawa IPY, Mahartini NN, Herawati S, Mulyantari NK. Acute Erythroleukemia (AML-M6) in one-year-old boy: a case report. Bali Medical Journal. 2022;11(3):1420-1425.
  4. Suwandari NLA, Lestari AAW, Wande IN, Wirawati IAP, Prabawa IPY. Acute Lymphoblastic Leukemia (ALL)-L2 in an adult woman: a case report. Bali Medical Journal. 2023;12(1):669-674.
  5. Rücker, FG Agrawal, M, Corbacioglu A, Weber D, Kapp-Schwoerer S, Gaidzik VI, et al. Measurable residual disease monitoring in acute myeloid leukemia with t (8; 21)(q22; q22. 1): results from the AML Study Group. Blood, The Journal of the American Society of Hematology. 2019;134(19):1608-1618.
  6. Short NJ, Zhou S, Fu C, Berry DA, Walter RB, Freeman SD, et al. Association of measurable residual disease with survival outcomes in patients with acute myeloid leukemia: a systematic review and meta-analysis. JAMA oncology. 2020;6(12):1890-1899.
  7. Czyz A, Nagler A. The role of measurable residual disease (MRD) in hematopoietic stem cell transplantation for hematological malignancies focusing on acute leukemia. International journal of molecular sciences. 2019;20(21):5362.
  8. Dillon LW, Hayati S, Roloff GW, Tunc I, Pirooznia M, Mitrofanova A, et al. Targeted RNA-sequencing for the quantification of measurable residual disease in acute myeloid leukemia. Haematologica. 2019;104(2):297.
  9. Blachly JS, Walter RB, Hourigan CS. The present and future of measurable residual disease testing in acute myeloid leukemia. Haematologica. 2022;107(12): 2810-2822.
  10. Brooimans RA, van der Velden VH, Boeckx N, Slomp J, Preijers F, Te Marvelde JG, et al. Immunophenotypic measurable residual disease (MRD) in acute myeloid leukemia: Is multicentric MRD assessment feasible?. Leukemia Research. 2019;76:39-47.
  11. Aitken MJ, Ravandi F, Patel KP, Short NJ. Prognostic and therapeutic implications of measurable residual disease in acute myeloid leukemia. Journal of Hematology & Oncology. 2021;14:1-15.
  12. Buckley SA, Wood BL, Othus M, Hourigan CS, Ustun C, Linden MA, et al. Minimal residual disease prior to allogeneic hematopoietic cell transplantation in acute myeloid leukemia: a meta-analysis. Haematologica. 2017;102(5):865.
  13. Liu FJ, Cheng WY, Lin XJ, Wang SY, Jiang TY, Ma TT, et al. Measurable residual disease detected by multiparameter Flow Cytometry and Sequencing improves prediction of Relapse and survival in Acute Myeloid Leukemia. Frontiers in Oncology. 2021;11:677833.
  14. Buccisano F, Maurillo L, Del Principe MI, Di Veroli A, De Bellis E, Biagi A, et al. Minimal residual disease as a biomarker for outcome prediction and therapy optimization in acute myeloid leukemia. Expert review of hematology. 2018;11(4):307-313.
  15. Dix, C, Lo TH, Clark G, Abadir E. Measurable residual disease in acute myeloid leukemia using flow cytometry: a review of where we are and where we are going. Journal of clinical medicine. 2020;9(6):1714.
  16. Ravandi F, Walter RB, Freeman SD. Evaluating measurable residual disease in acute myeloid leukemia. Blood advances. 2018;2(11):1356-1366.
  17. Percival MEM, Estey EH. Current treatment strategies for measurable residual disease in patients with acute myeloid leukemia. Cancer. 2019;125(18):3121-3130.
  18. Short NJ, Ravandi F. How close are we to incorporating measurable residual disease into clinical practice for acute myeloid leukemia?. Haematologica. 2019;104(8):1532.
  19. Pratz KW, Jonas BA, Pullarkat V, Recher C, Schuh AC, Thirman MJ, et al. Measurable residual disease response and prognosis in treatment-naïve acute myeloid leukemia with venetoclax and azacitidine. Journal of Clinical Oncology. 2022;40(8):855-865.
  20. Walter RB, Ofran Y, Wierzbowska A, Ravandi F, Hourigan CS, Ngai LL, et al. Measurable residual disease as a biomarker in acute myeloid leukemia: theoretical and practical considerations. Leukemia. 2021;35(6):1529-1538.
  21. Godwin CD, Zhou Y, Othus M, Asmuth MM, Shaw CM, Gardner KM, et al. Acute myeloid leukemia measurable residual disease detection by flow cytometry in peripheral blood vs bone marrow. Blood. 2021;137(4):569-572.
  22. Hasserjian RP, Steensma DP, Graubert TA, & Ebert BL. Clonal hematopoiesis and measurable residual disease assessment in acute myeloid leukemia. Blood. 2020;135(20):1729-1738.
  23. Maiti A, DiNardo CD, Wang SA, Jorgensen J, Kadia TM, Daver NG, et al. Prognostic value of measurable residual disease after venetoclax and decitabine in acute myeloid leukemia. Blood advances. 2021;5(7):1876-1883.

How to Cite

Lisa, S. (2023). Peranan klinis Measurable Residual Disease (MRD) sebagai faktor prognostik dan optimalisasi terapi pada Leukemia Myeloid Akut (LMA): sebuah tinjauan pustaka. Intisari Sains Medis, 14(1), 522–528. https://doi.org/10.15562/ism.v14i1.1707

HTML
0

Total
0

Share

Search Panel