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Measurable residual disease in acute myeloid leukemia

Research group

Active research

Project owner

Institute of Biomedicine

Area

Health and medicine

Topic

Clinical Laboratory Medicine Cancer and Oncology Medical Genetics

Short description

Linda Fogelstrand's research group is focused on improving diagnostics in acute myeloid leukemia (AML). Specifically, we develop and evaluate tools for analysis of small amounts of leukemic cells, measurable residual disease (MRD). These tools can help in treatment decisions and/or be used for monitoring for early detection of relapse. We readily transfer our results to clinical use at the Department of Clinical Chemistry and Center for Medical Genomics. While aiding the clinic with these tools, we also provide increased knowledge about the genetics and disease course of AML.

Acute myeloid leukemia (AML) is the most common form of acute leukemia. Unfortunately, the prognosis is poor, mostly due to high frequency of relapses using the current treatment strategies. Over the last years, it has become increasingly evident that the response to AML treatment, measurable residual disease (MRD), is a very strong prognostic factor. With the development of treatments in AML, early detection of a pending relapse by MRD analysis has become increasingly important. However, clinical usage of MRD analyses is hampered by problems with standardization and applicability in individual patients.

The overall aim of our research is to improve the basis for treatment decisions for children and adults with acute leukemia. We focus on analyses of MRD, and we strive towards enabling MRD analysis and monitoring possibilities for all patients with AML. We have developed a novel MRD analysis, deep sequencing, which is a next generation sequencing-based technique that measures leukemia-specific mutations with high sensitivity. We evaluate the efficacy of patient-tailored deep sequencing for response to treatment and early detection of relapse by conducting clinical studies. We also work with more established methods for MRD analysis; flow cytometry and RT-qPCR, and how methods can be combined for improved understanding.

Our work is closely linked to the hematology diagnostics departments at Sahlgrenska University Hospital. We collaborate closely with clinical hematologists and pediatric oncologists and take active part in the Nordic Society of Paediatric Haematology and Oncology (NOPHO), the new pediatric AML protocol CHIP-AML22, the Swedish and Nordic AML groups, and Genomics Medicine Sweden (GMS). Together with other hematology research groups at our institute, we aim for a fruitful hematological research environment. With our close connection to the clinical laboratories at the Department of Clinical Chemistry and the Center for Medical Genomics at Sahlgrenska University Hospital, we continuously translate our research results into clinical diagnostics, as exemplified with implementation of deep seqencing for MRD assessment in AML with mutation in NPM1 and/or FLT3-ITD.

Alumni: Azadeh Anbarlou, master project, Louise Kramén, master project, Adam Molnar, master project, Borhan Saeed, postdoctoral fellow.