The determination of remission or recurrence in patients with leukemia has been dependent on the cytological detection of chromosomal abnormalities. Their presence during treatment is accepted as a reliable prognostic marker, but chromosomal translocations are found in only 30 to 40% of patients with acute myeloid or lymphoblastic leukemias. The detection threshold is relatively high: for example, a patient starting with 10¹² leukemic cells at diagnosis might be erroneously considered in complete remission while still having 10¹⁰ abnormal cells in circulation. Competitive PCR is a much more sensitive method, but labor intensive and time-consuming. Recently, an automated, real-time quantitative PCR system has been developed and successfully tried in the treatment of leukemia patients.
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