Novel Tools for Diagnosis and Monitoring of AML

Abstract

In recent years, major advances in the understanding of acute myeloid leukemia (AML) pathogenesis, together with technological progress, have led us into a new era in the diagnosis and follow-up of patients with AML. A combination of immunophenotyping, cytogenetic and molecular studies are required for AML diagnosis, including the use of next-generation sequencing (NGS) gene panels to screen all genetic alterations with diagnostic, prognostic and/or therapeutic value. Regarding AML monitoring, multiparametric flow cytometry and quantitative PCR/RT-PCR are currently the most implemented methodologies for measurable residual disease (MRD) evaluation. Given the limitations of these techniques, there is an urgent need to incorporate new tools for MRD monitoring, such as NGS and digital PCR. This review aims to provide an overview of the different technologies used for AML diagnosis and MRD monitoring and to highlight the limitations and challenges of current versus emerging tools.

Keywords: AML; MRD monitoring; NGS; diagnosis; digital PCR; flow cytometry.

Figure 1

Tools for diagnosis and monitoring of AML. A combination of immunophenotyping and molecular studies is required for AML diagnosis and MRD monitoring. MRD: Measurable residual disease; LAIP: Leukemia-associated immunophenotype; DfN: Different from normal; qPCR: quantitative PCR; ddPCR: Droplet digital PCR.