TY - JOUR
T1 - Bone marrow evaluation for diagnosis and monitoring of acute myeloid leukemia
AU - Percival, Mary Elizabeth
AU - Lai, Catherine
AU - Estey, Elihu
AU - Hourigan, Christopher S.
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/7
Y1 - 2017/7
N2 - The diagnosis of acute myeloid leukemia (AML) can be made based on peripheral blood or bone marrow blasts. In this review, we will discuss the role of bone marrow evaluation and peripheral blood monitoring in the diagnosis, management, and follow up of AML patients. For patients with circulating blasts, it is reasonable to perform the necessary studies needed for diagnosis and risk stratification, including multiparametric flow cytometry, cytogenetics, and molecular analysis, on a peripheral blood specimen. The day 14 marrow is used to document hypocellularity in response to induction chemotherapy, but it is unclear if that assessment is necessary as it often does not affect immediate management. Currently, response assessments performed at count recovery for evaluation of remission and measurable residual disease rely on bone marrow sampling. For monitoring of relapse, peripheral blood evaluation may be adequate, but the sensitivity of bone marrow testing is in some cases superior. While bone marrow evaluation can certainly be avoided in particular situations, this cumbersome and uncomfortable procedure currently remains the de facto standard for response assessment.
AB - The diagnosis of acute myeloid leukemia (AML) can be made based on peripheral blood or bone marrow blasts. In this review, we will discuss the role of bone marrow evaluation and peripheral blood monitoring in the diagnosis, management, and follow up of AML patients. For patients with circulating blasts, it is reasonable to perform the necessary studies needed for diagnosis and risk stratification, including multiparametric flow cytometry, cytogenetics, and molecular analysis, on a peripheral blood specimen. The day 14 marrow is used to document hypocellularity in response to induction chemotherapy, but it is unclear if that assessment is necessary as it often does not affect immediate management. Currently, response assessments performed at count recovery for evaluation of remission and measurable residual disease rely on bone marrow sampling. For monitoring of relapse, peripheral blood evaluation may be adequate, but the sensitivity of bone marrow testing is in some cases superior. While bone marrow evaluation can certainly be avoided in particular situations, this cumbersome and uncomfortable procedure currently remains the de facto standard for response assessment.
KW - Acute myeloid leukemia
KW - Bone marrow evaluation
KW - Flow cytometry
KW - Measurable residual disease
KW - Morphology
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U2 - 10.1016/j.blre.2017.01.003
DO - 10.1016/j.blre.2017.01.003
M3 - Review article
C2 - 28190619
AN - SCOPUS:85011982199
SN - 0268-960X
VL - 31
SP - 185
EP - 192
JO - Blood Reviews
JF - Blood Reviews
IS - 4
ER -