Table 1. Different techniques for... | American Society of Hematology

Table 1.

Different techniques for measuring residual disease

Technique	Methods	Material	Cutoff	Advantage	Disadvantage
Multiparameter flow cytometry
LAIP¹³	Identify and follow a specific LAIP	BM	0.1%^*	LAIPs found in 90% of patients	Misses clonal evolution
Different from normal¹⁷	Identify leukemia cells in the empty spaces of normal BM flow plots	BM	Any MRD	No need for a diagnostic sample	Needs ample experience on regenerating normal BM
LAIP-based different from normal⁴⁸	Identify a LAIP at diagnosis but measure the whole panel to detect emerging cell populations	BM	0.1%	Usable for almost all patients	Still needs experience on background LAIP levels
Targeted molecular⁹
qPCR	NPM1	BM/PB	2% copies per ABL copies	Highly sensitive, rapid, standardizable	Can be low-level present with no clinical consequences
qPCR	Translocations^†	BM/PB	2% copies per ABL copies or 3-4 log reduction	Highly sensitive, rapid, standardizable	BM cannot be as measured frequently as PB
Next-generation sequencing
NGS^24,25	NPM1	BM/PB	0.01%-0.1%	Can be well standardized, reproducible, sensitive, flexible	Not yet standardized, not comparable to qPCR yet, expensive, time consuming
NGS^15,23,26	FLT3/ITD	BM/PB	0.01%	Can be well standardized, reproducible, sensitive, flexible	Expensive and clinical application needs to be validated

Technique	Methods	Material	Cutoff	Advantage	Disadvantage
Multiparameter flow cytometry
LAIP¹³	Identify and follow a specific LAIP	BM	0.1%^*	LAIPs found in 90% of patients	Misses clonal evolution
Different from normal¹⁷	Identify leukemia cells in the empty spaces of normal BM flow plots	BM	Any MRD	No need for a diagnostic sample	Needs ample experience on regenerating normal BM
LAIP-based different from normal⁴⁸	Identify a LAIP at diagnosis but measure the whole panel to detect emerging cell populations	BM	0.1%	Usable for almost all patients	Still needs experience on background LAIP levels
Targeted molecular⁹
qPCR	NPM1	BM/PB	2% copies per ABL copies	Highly sensitive, rapid, standardizable	Can be low-level present with no clinical consequences
qPCR	Translocations^†	BM/PB	2% copies per ABL copies or 3-4 log reduction	Highly sensitive, rapid, standardizable	BM cannot be as measured frequently as PB
Next-generation sequencing
NGS^24,25	NPM1	BM/PB	0.01%-0.1%	Can be well standardized, reproducible, sensitive, flexible	Not yet standardized, not comparable to qPCR yet, expensive, time consuming
NGS^15,23,26	FLT3/ITD	BM/PB	0.01%	Can be well standardized, reproducible, sensitive, flexible	Expensive and clinical application needs to be validated

qPCR, quantitative polymerase chain reaction.

^*

LAIP cells/CD45-expressing cells.

RUNX1-RUNX1T1, CBFB-MYH11, PML-RARA, KMT2A-MLLT3, DEK-NUP214, BCR-ABL.