Minimal Residual Disease Monitoring

The current induction and consolidation therapies result in molecular remission in most patients, as measured by reverse transcriptase (RT)-PCR for the PML::RARA fusion protein. Only 1% or less of patients show molecular evidence of disease at the end of consolidation therapy.[10,11] While two negative RT-PCR assays after completion of therapy are associated with long-term remission,[38] conversion from negative to positive RT-PCR is highly predictive of subsequent hematologic relapse.[39]

Patients with persistent or relapsing disease on the basis of PML::RARA fusion protein RT-PCR measurement may benefit from intervention with relapse therapies.[40,41] For more information, see the Treatment of Recurrent APL section.