1
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The influence of fixation of biological samples on cell count and marker expression stability in flow cytometric analyses. Cent Eur J Immunol 2021; 45:206-213. [PMID: 33456333 PMCID: PMC7792444 DOI: 10.5114/ceji.2020.95858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/11/2019] [Indexed: 11/24/2022] Open
Abstract
The most common applications of flow cytometry (FC) include diagnostics of haemato-oncological disorders, based on analysis of bone marrow, peripheral blood (PB), or cerebrospinal fluid (CSF) samples. A proper diagnostic process requires standardisation in setting the optimal time frame between material collection and the assay. Unfortunately, this might be difficult to achieve in daily practice due to unintended shipment delays, which might compromise large-scale multicentre studies. Thus, material fixation should be considered as a solution. The most widely used fixative agents are: paraformaldehyde, TransFix®, Cyto-Chex®, and serum-containing media. In this review, we attempted to summarise the literature data on the influence of sample storage under different temperatures and times combined with different fixation conditions on the cell count and marker expression levels. Based on the findings of several extensive studies employing fixed PB samples, it can be concluded that the performance of particular fixative greatly depends on the analysed marker and specific PB cell population expressing a given antigen. Preservation of absolute cell count was usually better in Cyto-Chex®-fixed PB samples, whereas TransFix® tended to better stabilise marker expression levels. CSF-based studies reveal that both serum-containing media and TransFix® can prevent cellular loss and enhance FC-based detection of leptomeningeal localisations of haematological malignancies, the latter being more available and having longer shelf-life. As both cell count and marker expression level are the main determinants of quality of biological samples dedicated to FC analyses, it remains to be addressed by the investigators which is the fixative of choice for their specific research aims.
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2
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Bhola RK, Das PK, Pradhan S, Chakraborty K, Mohapatra D, Samal P, Patra PC, Panda SS, Mishra SK. Multiplexing 8 colors with 12 antibodies in a single lymphoid screening tube by flow cytometry for evaluating suspected chronic lymphoproliferative disorders (CLPD). J Hematop 2019. [DOI: 10.1007/s12308-019-00376-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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3
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Drokow EK, Sun K, Ahmed HAW, Akpabla GS, Song J, Shi M. Circulating microRNA as diagnostic biomarkers for haematological cancers: a systematic review and meta-analysis. Cancer Manag Res 2019; 11:4313-4326. [PMID: 31190996 PMCID: PMC6520596 DOI: 10.2147/cmar.s199126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/10/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose: Recent studies have validated microRNAs (miRNAs) as a diagnostic biomarker for haematological cancers. This study aimed to estimate the overall diagnostic accuracy of circulating miRNAs in haematological malignancies. Materials and Methods: Multiple databases (Google Scholar, PubMed, EMBASE, Cochrane Library,) were searched until 19th August 2017. Results: The meta-analysis included 50 studies from 20 publications. The diagnostic accuracy was assessed by pooled specificity, sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve area (AUC) by random effect model. We used QUADAS (Quality Assessment for diagnostic accuracy studies) to evaluate the quality of the included studies. To perform the meta-analysis, we used Meta-Disk 1.4, Revman 5.3 and Stata 12.0 software. High diagnostic accuracy was demonstrated, with a sensitivity of 0.81, a specificity of 0.85, a PLR of 5.28, an NLR of 0.22, a DOR of 30.39, and an AUC of 0.91. Subgroup analyses showed better outcomes for the African population, combined miRNAs and leukaemia patients compared with other subgroups. Conclusion: Our results indicated that circulating miRNAs especially combined miRNA can be used as a diagnostic marker in haematological cancers.
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Affiliation(s)
- Emmanuel Kwateng Drokow
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Kai Sun
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Hafiz Abdul Waqas Ahmed
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Gloria Selorm Akpabla
- Department of Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Juanjuan Song
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Mingyue Shi
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
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4
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Gómez-Almaguer D, Marcos-Ramírez ER, Montaño-Figueroa EH, Ruiz-Argüelles GJ, Best-Aguilera CR, López-Sánchez MDC, Barrera-Chairez E, López-Arrollo JL, Ramos-Peñafiel CO, León-Peña A, González-López EE, Rivas-García PE, Tellez-Hinojosa CA, Gómez-De León A, Jaime-Pérez JC. Acute Leukemia Characteristics are Different Around the World: the Mexican Perspective. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:46-51. [DOI: 10.1016/j.clml.2016.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/05/2016] [Accepted: 09/08/2016] [Indexed: 01/19/2023]
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5
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Gupta S, Chatterjee T, Sharma S, Sharma A, Ganguly P, Singh J, Das S. Flowcytometric comparative analysis in acute leukemias between Indian and proposed minimal screening panel. Med J Armed Forces India 2016; 72:220-30. [PMID: 27546960 PMCID: PMC4982965 DOI: 10.1016/j.mjafi.2016.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 01/06/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia and acute lymphoid leukemia differ substantially in response to therapy and course, and accurate differentiation of the two is fundamental to therapeutic decisions. Immunophenotyping is used for this purpose, and various guidelines have been proposed regarding a minimal screening antibody panel. Most of them have been found inefficient. METHODS Eighty-two cases of consecutive acute leukemias reporting to this hospital over a period of two years were included in the study. Peripheral blood smear, bone marrow aspirate, and bone marrow biopsy were studied using morphology, cytochemical stains, and relevant immunohistochemical stains on selected biopsy specimens. Flowcytometry analysis was carried out using Indian consensus screening panel and our proposed minimal screening panel (PMSP) for comparison. RESULT Immunophenotyping using PMSP resulted in 95.12% accurate diagnosis versus Indian consensus minimal screening panel (ICMSP) with an accuracy of 92.68%. This result was statistically significant as per Chi Square tests. CONCLUSION PMSP can be used as a substitute for ICMSP, since it includes lineage-specific cytoplasmic antibodies, as well as lesser number of monoclonal antibodies, and enables us to diagnose mixed lineage leukemia. Fewer markers can be linked to a lower cost as well, which is relevant in a developing economy.
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Affiliation(s)
- Srishti Gupta
- Resident (Pathology), Army Hospital (R&R), New Delhi 110010, India
| | | | - Sanjeevan Sharma
- Senior Adviser (Med & Hematology), Command Hospital (Southern Command), Pune 411040, India
| | - Ajay Sharma
- Consultant & Head (Hematology), Army Hospital (R&R), New Delhi 110010, India
| | - Prosenjit Ganguly
- Senior Adviser (Pathology), Command Hospital (Eastern Command), Kolkata, India
| | - Jasjit Singh
- Senior Adviser (Med & Hematology), Army Hospital (R&R), New Delhi 110010, India
| | - Satyaranjan Das
- Senior Adviser (Paediatrics & Hematology), INHS Asvini, Colaba, Mumbai, India
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6
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Identification of circulating microRNAs as biomarkers in diagnosis of hematologic cancers: a meta-analysis. Tumour Biol 2014; 35:10467-78. [DOI: 10.1007/s13277-014-2364-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/14/2014] [Indexed: 01/08/2023] Open
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7
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Ikoma MRV, Sandes AF, Thiago LS, Cavalcanti Júnior GB, Lorand-Metze IGH, Costa ES, Pimenta G, Santos-Silva MC, Bacal NS, Yamamoto M, Souto EX. First proposed panels on acute leukemia for four-color immunophenotyping by flow cytometry from the Brazilian group of flow cytometry-GBCFLUX. CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 88:194-203. [DOI: 10.1002/cyto.b.21175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 03/26/2014] [Accepted: 03/28/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Maura R. V. Ikoma
- Hospital Amaral Carvalho; Laboratório de Citometria de Fluxo do Hemonúcleo Regional de Jau; São Paulo Brazil
| | - Alex F. Sandes
- Division of Hematology; Fleury Group; São Paulo Brazil
- Division of Hematology and Blood Transfusion Medicine; Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP-EPM); Brazil
| | - Leandro S. Thiago
- Brazilian National Cancer Institute (INCa), Cancer Research Center; Rio de Janeiro Brazil
| | | | | | - Elaine S. Costa
- Pediatric Institute IPPMG, Universidade Federal do Rio de Janeiro (UFRJ); Rio de Janeiro Brazil
| | - Glicinia Pimenta
- Universidade Federal do Rio de Janeiro; Brazil
- Laboratório Diagnósticos da América; Rio de Janeiro Brazil
| | | | - Nydia S. Bacal
- Hospital Israelita Albert Einstein; São Paulo Brazil
- Centro de Hematologia de; São Paulo
| | - Mihoko Yamamoto
- Division of Hematology and Blood Transfusion Medicine; Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP-EPM); Brazil
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8
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Ruiz-Argüelles GJ, Morales-Toquero A, Manzano C, Ruiz-Delgado GJ, Jaramillo P, Gonzalez-Carrillo ML, Reyes-Núñez V. t(8;21) (q22;q22) Acute myelogenous leukemia in México: A single institution experience. Hematology 2013; 11:235-8. [PMID: 17178661 DOI: 10.1080/10245330600702893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We analyze the prevalence and clinical features of a group of patients with t(8;21) (q22;q22) acute myeloblastic leukemia, identified in a single institution in México over a 10-year period. Fifteen patients presented at the Centro de Hematología y Medicina Interna de Puebla from February 1995 to August 2005; only nine were treated and followed in the institution. Median age was 24 years, (range 7-49); there was only one male. According to the French-American-British (FAB) morphological classification of leukemia, the morphology was M2 in four cases, M4 in three cases, M3 in one case and M0 in one. In addition to the myeloid markers, lymphoid markers were identified in 6 patients. Patients were induced to remission with combined chemotherapy and three subsequently underwent bone marrow transplantation (BMT). The median overall and disease-free survival has not been reached, being above 3390 days, the probability of survival at this time was 73%. In this single-center experience in México, we found that the t(8;21) (q22;q22) variant of leukemia was more frequent than in Caucasian populations, that the co-expression of lymphoid markers in the blast cells is very frequent and that this malignancy is associated with a relatively good prognosis.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Child, Preschool
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 21/ultrastructure
- Chromosomes, Human, Pair 8/genetics
- Chromosomes, Human, Pair 8/ultrastructure
- Combined Modality Therapy
- Core Binding Factor Alpha 2 Subunit/genetics
- Cytarabine/administration & dosage
- Disease-Free Survival
- Doxorubicin/administration & dosage
- Female
- Humans
- Infant
- Kaplan-Meier Estimate
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/epidemiology
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/surgery
- Male
- Mexico/epidemiology
- Middle Aged
- Oncogene Proteins, Fusion/genetics
- Peripheral Blood Stem Cell Transplantation/statistics & numerical data
- Prevalence
- Prospective Studies
- RUNX1 Translocation Partner 1 Protein
- Remission Induction
- Salvage Therapy
- Translocation, Genetic
- Transplantation, Autologous/statistics & numerical data
- Transplantation, Homologous/statistics & numerical data
- Treatment Outcome
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9
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Ribera J, Zamora L, Juncà J, Rodríguez I, Marcé S, Cabezón M, Millá F. Usefulness of IGH/TCR PCR studies in lymphoproliferative disorders with inconclusive clonality by flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 86:25-31. [DOI: 10.1002/cyto.b.21118] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 06/28/2013] [Accepted: 07/12/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Jordi Ribera
- IJC-Institut de Recerca Contra la Leucèmia Josep Carreras; Universitat Autónoma de Barcelona
| | - Lurdes Zamora
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
| | - Jordi Juncà
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
| | - Inés Rodríguez
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
| | - Silvia Marcé
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
| | - Marta Cabezón
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
| | - Fuensanta Millá
- IJC-ICO Badalona; Hospital Germans Trias i Pujol; Universitat Autónoma de Barcelona
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10
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Solano-Genesta M, Tarín-Arzaga L, Velasco-Ruiz I, Lutz-Presno JA, González-Llano O, Mancías-Guerra C, Rodríguez-Romo L, Ruiz-Delgado GJ, Ruiz-Argüelles GJ, Jaime-Pérez JC, Gómez-Almaguer D. CD20 expression in B-cell precursor acute lymphoblastic leukemia is common in Mexican patients and lacks a prognostic value. Hematology 2013; 17:66-70. [DOI: 10.1179/102453312x13221316477741] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Manuel Solano-Genesta
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Luz Tarín-Arzaga
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Ileana Velasco-Ruiz
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | | | - Oscar González-Llano
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Consuelo Mancías-Guerra
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Laura Rodríguez-Romo
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - Guillermo J. Ruiz-Delgado
- Centro de Hematología y Medicina InternaClinica RUIZ, Puebla, Pue, Mexico
- Laboratorios Clínicos de Pueblo, Clínica Ruiz, Pueblo, Mexico
| | - Guillermo J. Ruiz-Argüelles
- Centro de Hematología y Medicina InternaClinica RUIZ, Puebla, Pue, Mexico
- Laboratorios Clínicos de Pueblo, Clínica Ruiz, Pueblo, Mexico
| | - José Carlos Jaime-Pérez
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
| | - David Gómez-Almaguer
- Servicio de Hematología, Hospital Universitario, ‘Dr. José E. González’ Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico
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11
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Einwallner E, Subasic A, Strasser A, Augustin D, Thalhammer R, Steiner I, Schwarzinger I. Lysis matters: Red cell lysis with FACS Lyse affects the flow cytometric enumeration of circulating leukemic blasts. J Immunol Methods 2013; 390:127-32. [DOI: 10.1016/j.jim.2013.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 11/23/2012] [Accepted: 01/28/2013] [Indexed: 01/12/2023]
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12
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Kalina T, Flores-Montero J, van der Velden VHJ, Martin-Ayuso M, Böttcher S, Ritgen M, Almeida J, Lhermitte L, Asnafi V, Mendonça A, de Tute R, Cullen M, Sedek L, Vidriales MB, Pérez JJ, te Marvelde JG, Mejstrikova E, Hrusak O, Szczepański T, van Dongen JJM, Orfao A. EuroFlow standardization of flow cytometer instrument settings and immunophenotyping protocols. Leukemia 2012; 26:1986-2010. [PMID: 22948490 PMCID: PMC3437409 DOI: 10.1038/leu.2012.122] [Citation(s) in RCA: 525] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The EU-supported EuroFlow Consortium aimed at innovation and standardization of immunophenotyping for diagnosis and classification of hematological malignancies by introducing 8-color flow cytometry with fully standardized laboratory procedures and antibody panels in order to achieve maximally comparable results among different laboratories. This required the selection of optimal combinations of compatible fluorochromes and the design and evaluation of adequate standard operating procedures (SOPs) for instrument setup, fluorescence compensation and sample preparation. Additionally, we developed software tools for the evaluation of individual antibody reagents and antibody panels. Each section describes what has been evaluated experimentally versus adopted based on existing data and experience. Multicentric evaluation demonstrated high levels of reproducibility based on strict implementation of the EuroFlow SOPs and antibody panels. Overall, the 6 years of extensive collaborative experiments and the analysis of hundreds of cell samples of patients and healthy controls in the EuroFlow centers have provided for the first time laboratory protocols and software tools for fully standardized 8-color flow cytometric immunophenotyping of normal and malignant leukocytes in bone marrow and blood; this has yielded highly comparable data sets, which can be integrated in a single database.
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Affiliation(s)
- T Kalina
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University (DPH/O), Prague, Czech Republic
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13
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van Dongen JJM, Orfao A. EuroFlow: Resetting leukemia and lymphoma immunophenotyping. Basis for companion diagnostics and personalized medicine. Leukemia 2012; 26:1899-907. [PMID: 22948488 PMCID: PMC3437406 DOI: 10.1038/leu.2012.121] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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14
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van Dongen JJM, Lhermitte L, Böttcher S, Almeida J, van der Velden VHJ, Flores-Montero J, Rawstron A, Asnafi V, Lécrevisse Q, Lucio P, Mejstrikova E, Szczepański T, Kalina T, de Tute R, Brüggemann M, Sedek L, Cullen M, Langerak AW, Mendonça A, Macintyre E, Martin-Ayuso M, Hrusak O, Vidriales MB, Orfao A. EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytes. Leukemia 2012; 26:1908-75. [PMID: 22552007 PMCID: PMC3437410 DOI: 10.1038/leu.2012.120] [Citation(s) in RCA: 662] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 02/14/2012] [Accepted: 04/19/2012] [Indexed: 12/21/2022]
Abstract
Most consensus leukemia & lymphoma antibody panels consist of lists of markers based on expert opinions, but they have not been validated. Here we present the validated EuroFlow 8-color antibody panels for immunophenotyping of hematological malignancies. The single-tube screening panels and multi-tube classification panels fit into the EuroFlow diagnostic algorithm with entries defined by clinical and laboratory parameters. The panels were constructed in 2-7 sequential design-evaluation-redesign rounds, using novel Infinicyt software tools for multivariate data analysis. Two groups of markers are combined in each 8-color tube: (i) backbone markers to identify distinct cell populations in a sample, and (ii) markers for characterization of specific cell populations. In multi-tube panels, the backbone markers were optimally placed at the same fluorochrome position in every tube, to provide identical multidimensional localization of the target cell population(s). The characterization markers were positioned according to the diagnostic utility of the combined markers. Each proposed antibody combination was tested against reference databases of normal and malignant cells from healthy subjects and WHO-based disease entities, respectively. The EuroFlow studies resulted in validated and flexible 8-color antibody panels for multidimensional identification and characterization of normal and aberrant cells, optimally suited for immunophenotypic screening and classification of hematological malignancies.
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Affiliation(s)
- J J M van Dongen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam (Erasmus MC), Rotterdam, The Netherlands.
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15
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Costa ES, Pedreira CE, Barrena S, Lecrevisse Q, Flores J, Quijano S, Almeida J, del Carmen García- Macias M, Bottcher S, Van Dongen JJM, Orfao A. Automated pattern-guided principal component analysis vs expert-based immunophenotypic classification of B-cell chronic lymphoproliferative disorders: a step forward in the standardization of clinical immunophenotyping. Leukemia 2010; 24:1927-33. [PMID: 20844562 PMCID: PMC3035971 DOI: 10.1038/leu.2010.160] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 06/09/2010] [Accepted: 06/17/2010] [Indexed: 12/21/2022]
Abstract
Immunophenotypic characterization of B-cell chronic lymphoproliferative disorders (B-CLPD) is becoming increasingly complex due to usage of progressively larger panels of reagents and a high number of World Health Organization (WHO) entities. Typically, data analysis is performed separately for each stained aliquot of a sample; subsequently, an expert interprets the overall immunophenotypic profile (IP) of neoplastic B-cells and assigns it to specific diagnostic categories. We constructed a principal component analysis (PCA)-based tool to guide immunophenotypic classification of B-CLPD. Three reference groups of immunophenotypic data files-B-cell chronic lymphocytic leukemias (B-CLL; n = 10), mantle cell (MCL; n = 10) and follicular lymphomas (FL; n = 10)--were built. Subsequently, each of the 175 cases studied was evaluated and assigned to either one of the three reference groups or to none of them (other B-CLPD). Most cases (89%) were correctly assigned to their corresponding WHO diagnostic group with overall positive and negative predictive values of 89 and 96%, respectively. The efficiency of the PCA-based approach was particularly high among typical B-CLL, MCL and FL vs other B-CLPD cases. In summary, PCA-guided immunophenotypic classification of B-CLPD is a promising tool for standardized interpretation of tumor IP, their classification into well-defined entities and comprehensive evaluation of antibody panels.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD/immunology
- Automation
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Female
- Flow Cytometry/methods
- Humans
- Immunoglobulin A/immunology
- Immunophenotyping/methods
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma/immunology
- Lymphoma/pathology
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/immunology
- Lymphoma, Mantle-Cell/pathology
- Male
- Middle Aged
- Predictive Value of Tests
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Affiliation(s)
- E S Costa
- Pediatrics Institute Martagão Gesteira—IPPMG, Federal University of Rio de Janeiro—UFRJ, Rio de Janeiro, Brazil
| | - C E Pedreira
- Faculty of Medicine and COPPE—Engineering Graduate Program, Federal University of Rio de Janeiro—UFRJ, Rio de Janeiro, Brazil
| | - S Barrena
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
| | - Q Lecrevisse
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
| | - J Flores
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
| | - S Quijano
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
| | - J Almeida
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
| | | | - S Bottcher
- University of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J J M Van Dongen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Orfao
- Cytometry Service, Department of Medicine and Cancer Research Center (IBMCC, University of Salamanca-CSIC), University of Salamanca, Salamanca, Spain
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da Costa ES, Peres RT, Almeida J, Lécrevisse Q, Arroyo ME, Teodósio C, Pedreira CE, van Dongen JJM, Orfao A. Harmonization of light scatter and fluorescence flow cytometry profiles obtained after staining peripheral blood leucocytes for cell surface-only versus intracellular antigens with the Fix & Perm reagent. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 78:11-20. [PMID: 19575389 DOI: 10.1002/cyto.b.20486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Staining for intracellular markers with the Fix & Perm reagent is associated with variations in the scatter properties of leucocytes, limiting automated analysis of flow cytometry (FCM) data. Here, we investigated those variables significantly contributing to changes in the light scatter, autofluorescence, and bcl2 staining characteristics of peripheral blood (PB) leucocytes, after fixation with Fix & Perm. Our major aim was to evaluate a new mathematical approach for automated harmonization of FCM data from datafiles corresponding to aliquots of a sample treated with cell-surface-only versus Fix & Perm intracellular staining techniques. Overall, neither the anticoagulant used nor sample storage for <24 h showed significant impact on the light scatter and fluorescence properties of PB leucocytes; similarly, the duration of the fixation period (once >15 min were used) had a minimum impact on the FCM properties of PB leucocytes. Conversely, changes in cell/protein concentrations and the fixative/sample (vol/vol) ratio had a clear impact on the light scatter features of some populations of leucocytes. Accordingly, lower cell/protein concentrations were associated with lower scatter values, particularly for the neutrophils. Such changes could be partially corrected through the use of higher fixative to sample volume ratios. Despite the variable changes detected between aliquots of the same sample treated with cell surface-only versus intracellular staining procedures, the new mathematical approach here proposed and evaluated for automated harmonization of common parameters in both datafiles, could correct the FCM profiles of leucocytes derived from cells undergoing conventional fixation/permeabilization procedures, and made them indistinguishable from those corresponding to aliquots of the same sample treated with cell-surface-only staining techniques.
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Affiliation(s)
- Elaine Sobral da Costa
- Instituto de Pediatria e Puericultura Martagão Gesteira and Programa de Pós-Graduação em Clínica Médica, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Pedreira CE, Costa ES, Almeida J, Fernandez C, Quijano S, Flores J, Barrena S, Lecrevisse Q, Van Dongen JJM, Orfao A. A probabilistic approach for the evaluation of minimal residual disease by multiparameter flow cytometry in leukemic B-cell chronic lymphoproliferative disorders. Cytometry A 2009; 73A:1141-50. [PMID: 18836994 DOI: 10.1002/cyto.a.20638] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multiparameter flow cytometry has become an essential tool for monitoring response to therapy in hematological malignancies, including B-cell chronic lymphoproliferative disorders (B-CLPD). However, depending on the expertise of the operator minimal residual disease (MRD) can be misidentified, given that data analysis is based on the definition of expert-based bidimensional plots, where an operator selects the subpopulations of interest. Here, we propose and evaluate a probabilistic approach based on pattern classification tools and the Bayes theorem, for automated analysis of flow cytometry data from a group of 50 B-CLPD versus normal peripheral blood B-cells under MRD conditions, with the aim of reducing operator-associated subjectivity. The proposed approach provided a tool for MRD detection in B-CLPD by flow cytometry with a sensitivity of < or =8 x 10(-5) (median of < or =2 x 10(-7)). Furthermore, in 86% of B-CLPD cases tested, no events corresponding to normal B-cells were wrongly identified as belonging to the neoplastic B-cell population at a level of < or =10(-7). Thus, this approach based on the search for minimal numbers of neoplastic B-cells similar to those detected at diagnosis could potentially be applied with both a high sensitivity and specificity to investigate for the presence of MRD in virtually all B-CLPD. Further studies evaluating its efficiency in larger series of patients, where reactive conditions and non-neoplastic disorders are also included, are required to confirm these results.
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Affiliation(s)
- C E Pedreira
- Faculty of Medicine and COPPE-PEE Engineering Graduate Program, UFRJ/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Gujral S, Subramanian PG, Dasgupta A. Diversity amongst various guidelines for immunophenotyping. Cytometry A 2009; 75:560-1. [PMID: 19504568 DOI: 10.1002/cyto.a.20739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Brooimans RA, Kraan J, van Putten W, Cornelissen JJ, Löwenberg B, Gratama JW. Flow cytometric differential of leukocyte populations in normal bone marrow: Influence of peripheral blood contamination1. CYTOMETRY PART B-CLINICAL CYTOMETRY 2009; 76:18-26. [DOI: 10.1002/cyto.b.20439] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 06/04/2008] [Indexed: 11/05/2022]
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20
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Mirabelli P, Di Noto R, Lo Pardo C, Morabito P, Abate G, Gorrese M, Raia M, Pascariello C, Scalia G, Gemei M, Mariotti E, Del Vecchio L. Extended flow cytometry characterization of normal bone marrow progenitor cells by simultaneous detection of aldehyde dehydrogenase and early hematopoietic antigens: implication for erythroid differentiation studies. BMC PHYSIOLOGY 2008; 8:13. [PMID: 18510759 PMCID: PMC2426712 DOI: 10.1186/1472-6793-8-13] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Accepted: 05/29/2008] [Indexed: 12/19/2022]
Abstract
Background Aldehyde dehydrogenase (ALDH) is a cytosolic enzyme highly expressed in hematopoietic precursors from cord blood and granulocyte-colony stimulating factor mobilized peripheral blood, as well as in bone marrow from patients with acute myeloblastic leukemia. As regards human normal bone marrow, detailed characterization of ALDH+ cells has been addressed by one single study (Gentry et al, 2007). The goal of our work was to provide new information about the dissection of normal bone marrow progenitor cells based upon the simultaneous detection by flow cytometry of ALDH and early hematopoietic antigens, with particular attention to the expression of ALDH on erythroid precursors. To this aim, we used three kinds of approach: i) multidimensional analytical flow cytometry, detecting ALDH and early hematopoietic antigens in normal bone marrow; ii) fluorescence activated cell sorting of distinct subpopulations of progenitor cells, followed by in vitro induction of erythroid differentiation; iii) detection of ALDH+ cellular subsets in bone marrow from pure red cell aplasia patients. Results In normal bone marrow, we identified three populations of cells, namely ALDH+CD34+, ALDH-CD34+ and ALDH+CD34- (median percentages were 0.52, 0.53 and 0.57, respectively). As compared to ALDH-CD34+ cells, ALDH+CD34+ cells expressed the phenotypic profile of primitive hematopoietic progenitor cells, with brighter expression of CD117 and CD133, accompanied by lower display of CD38 and CD45RA. Of interest, ALDH+CD34- population disclosed a straightforward erythroid commitment, on the basis of three orders of evidences. First of all, ALDH+CD34- cells showed a CD71bright, CD105+, CD45- phenotype. Secondly, induction of differentiation experiments evidenced a clear-cut expression of glycophorin A (CD235a). Finally, ALDH+CD34- precursors were not detectable in patients with pure red cell aplasia (PRCA). Conclusion Our study, comparing surface antigen expression of ALDH+/CD34+, ALDH-/CD34+ and ALDH+/CD34- progenitor cell subsets in human bone marrow, clearly indicated that ALDH+CD34- cells are mainly committed towards erythropoiesis. To the best of our knowledge this finding is new and could be useful for basic studies about normal erythropoietic differentiation as well as for enabling the employment of ALDH as a red cell marker in polychromatic flow cytometry characterization of bone marrow from patients with aplastic anemia and myelodysplasia.
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Affiliation(s)
- Peppino Mirabelli
- Servizio di Immunoematologia e Medicina Trasfusionale, Ospedale A. Cardarelli, Napoli, Italy.
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Loken MR, van de Loosdrecht A, Ogata K, Orfao A, Wells DA. Flow cytometry in myelodysplastic syndromes: Report from a working conference. Leuk Res 2008; 32:5-17. [PMID: 17576013 DOI: 10.1016/j.leukres.2007.04.020] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Revised: 04/20/2007] [Accepted: 04/21/2007] [Indexed: 12/01/2022]
Abstract
Since new therapeutic strategies are emerging in myelodysplastic syndromes (MDS), a refined diagnostic procedure of the several subgroups of MDS is of increased importance. Multidimensional flow cytometry may add significantly to a more detailed analysis of the hematopoietic lineages with respect to qualification and quantification of bone marrow cells and is described in detail. Clearly defined aberrancies on myeloid immature and maturing cells are now identified with possible impact on diagnosis, classification and prognostication in the near feature.
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