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- Title
Diagnostic Strategies in the Indication to Allogeneic Hematopoietic Transplantation in AML.
- Authors
Bacher, Ulrike; Klyuchnikov, Evgeny; Kröger, Nicolaus; Haferlach, Claudia; Schnittger, Susanne; Kern, Wolfgang; Zander, Axel Rolf; Haferlach, Torsten
- Abstract
leukemia (AML) represents a biologically and prognostically extremely heterogeneous disorder, the indication to allogeneic hematopoietic transplantation [stem cell transplantation (SCT)] needs to be exactly defined according to the unique characteristics of the disease in each separate case. Different diagnostic methods, such as cytomorphology, cytogenetics, fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR)-based methods, and multiparameter flow cytometry (MFC), have to be combined to provide the basis for the best therapeutic strategy. The karyotypes as defined with chromosome banding analysis and FISH provide strong prognostically relevant parameters. With PCR-based methods, also patients from the normal karyotype group could be further subcategorized according to specific mutations in >85% of cases. Here, the FLT3 and the NPM1 mutations are crucial for the definition of prognosis and for the selection of patients for allogeneic SCT (allo-SCT). With regard to some novel markers as mutations of the TET2 gene, it remains to be seen whether these might become relevant for the indication to SCT. An increasing panel of parameters is available to assess the minimal residual disease (MRD) load, which can be illustrated using quantitative PCR for the NPM1 mutations. It has to be seen whether MRD assessment with immunophenotyping with MFC might as well become relevant for the indication to SCT in AML. Thus, the panel of hematological parameters and methods that influences the indication to allo-SCT in AML is still continuously expanding. This review provides an overview on the most important technologies and relevant parameters that influence the decision to allo-SCT now or might achieve an influence in the future.
- Subjects
HEMATOPOIETIC agents; LEUKEMIA; HOMOGRAFTS; STEM cell transplantation; KARYOTYPES; CYTOGENETICS; GENETIC mutation; PATIENTS
- Publication
European Journal of Clinical & Medical Oncology, 2011, Vol 3, Issue 1, p14
- ISSN
1759-8958
- Publication type
Article