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Abstract FITC, PE, ECD, PC5 & PC7 labeled anti-CDs were used to evaluate MRD on blast cells gated on CD45 in all hematological remitted patients. The choice of monoclonal antibodies used was tailored in each subject according to the original panel. Our results show that 2 different patient risk groups can be clearly identified based on the number of residual cells displaying leukemia-associated phenotypes (LAP+ cells). Thus, none of the patients with fewer than 0.01 LAP+ cells have relapsed so far (good risk), whereas in the group at poor risk (MRD greater than 0.01) around 61.8% of them relapsed during follow up. In addition about 52.6% of post induction cases had MRD –ve and 100% of relapsed cases had MRD +ve results and the best cut off point for MRD detection is 0.095. On the other hand 60% of Post consolidation cases with remission had MRD –ve and 100% of relapsed cases had MRD +ve results and best cut off point for MRD in post induction phase is around 0.05. This means that there is a positive correlation between the detection of MRD post treatment and the fate of patients with acute myeloid leukemia. We concluded that assessment of minimal residual disease in AML is of great value in determination of prognosis of the disease and its outcome and it is of great value to determine the levels of minimal residual disease (MRD) during the course of therapy and to stratify patient to identify high risk patient and to plan the therapeutic program accordingly. In addition we explore that the level of MRD and cytogenetic abnormalities influence the fate of patients not only after chemotherapy but also after BM transplantation and additional measures may be needed later on to protect patients with myeloid malignancy from relapse. |