Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

What do we mean by sensitivity when we talk about detecting minimal residual disease?

Leukemia volume 22, pages 1638–1639 (2008)Cite this article

Detection of minimal residual disease (MRD) has become a strong diagnostic tool in acute leukemia. In acute lymphoblastic leukemia, it is widely used for risk-adapted therapy. In acute myeloid leukemia (AML), it is still a matter of debate how best to measure MRD. A number of different methods are competing.1, 2

In the comparison of these methods, it has become common practice to advertise the high sensitivity of one or the other method. In this context, sensitivity usually means the lowest proportion of leukemic cells that can be measured. Unfortunately, this type of sensitivity is not only a technically incorrect use of the word, but also information with very limited relevance. The crucial point is not the lowest proportion of leukemic cells that is measurable, but the lowest proportion of leukemic cells that are clearly distinguishable from any healthy or, even more importantly, any leukemia-free, regenerating bone marrow. Here we discuss the importance of these differences and the consequences for comparing different methods of detecting MRD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Yin JA, Grimwade D . Minimal residual disease evaluation in acute myeloid leukaemia. Lancet 2002; 360: 160–162.

    Article  PubMed  Google Scholar 

  2. Campana D . Minimal residual disease studies in acute leukemia. Am J Clin Pathol 2004; 122 (Suppl): S47–S57.

    PubMed  Google Scholar 

  3. Lapillonne H, Renneville A, Auvrignon A, Flamant C, Blaise A, Perot C et al. High WT1 expression after induction therapy predicts high risk of relapse and death in pediatric acute myeloid leukemia. J Clin Oncol 2006; 24: 1507–1515.

    Article  CAS  PubMed  Google Scholar 

  4. Steinbach D, Schramm A, Eggert A, Onda M, Dawczynski K, Rump A et al. Identification of a set of seven genes for the monitoring of minimal residual disease in pediatric acute myeloid leukemia. Clin Cancer Res 2006; 12: 2434–2441.

    Article  CAS  PubMed  Google Scholar 

  5. Matsushita M, Ikeda H, Kizaki M, Okamoto S, Ogasawara M, Ikeda Y et al. Quantitative monitoring of the PRAME gene for the detection of minimal residual disease in leukaemia. Br J Haematol 2001; 112: 916–926.

    Article  CAS  PubMed  Google Scholar 

  6. Kern W, Danhauser-Riedl S, Ratei R, Schnittger S, Schoch C, Kolb HJ et al. Detection of minimal residual disease in unselected patients with acute myeloid leukemia using multiparameter flow cytometry for definition of leukemia-associated immunophenotypes and determination of their frequencies in normal bone marrow. Haematologica 2003; 88: 646–653.

    PubMed  Google Scholar 

  7. van der Velden VH, Cazzaniga G, Schrauder A, Hancock J, Bader P, Panzer-Grumayer ER, et al., European Study Group on MRD detection in ALL (ESG-MRD-ALL). Analysis of minimal residual disease by Ig/TCR gene rearrangements: guidelines for interpretation of real-time quantitative PCR data. Leukemia 2007; 21: 604–611.

    Article  CAS  PubMed  Google Scholar 

  8. San Miguel JF, Vidriales MB, Lopez-Berges C, Diaz-Mediavilla J, Gutierrez N, Canizo C et al. Early immunophenotypical evaluation of minimal residual disease in acute myeloid leukemia identifies different patient risk groups and may contribute to postinduction treatment stratification. Blood 2001; 98: 1746–1751.

    Article  CAS  PubMed  Google Scholar 

  9. Venditti A, Buccisano F, Del Poeta G, Maurillo L, Tamburini A, Cox C et al. Level of minimal residual disease after consolidation therapy predicts outcome in acute myeloid leukemia. Blood 2000; 96: 3948–3952.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Oncology, University Hospital Ulm, Ulm, Germany

    D Steinbach & K-M Debatin

Authors
  1. D Steinbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K-M Debatin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Steinbach.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steinbach, D., Debatin, KM. What do we mean by sensitivity when we talk about detecting minimal residual disease?. Leukemia 22, 1638–1639 (2008). https://doi.org/10.1038/leu.2008.33

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leu.2008.33

This article is cited by

Search

Advanced search

Quick links