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Callebaut K, Gijbels E, Vanbesien J, Deeren D, Van Droogenbroeck J, Emmerechts J, Moreau E. Evaluation of AQUIOS STEM, a novel method for automated CD34+ stem cell enumeration using flow cytometry. Int J Lab Hematol 2024; 46:657-664. [PMID: 38421076 DOI: 10.1111/ijlh.14253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for various diseases. The measurement of CD34+ cells is crucial to schedule the peripheral blood stem cell collection and assess the engraftment potential of the apheresis product. The AQUIOS STEM system has been introduced as a novel application on the AQUIOS CL, a fully automated flow cytometer, for the enumeration of CD34+ hematopoietic progenitor cells (HPCs) in accordance with the The International Society for Hematotherapy and Graft Engineering guidelines. This study aimed to assess the potential of the novel AQUIOS STEM system versus currently used systems including the FACSCanto-II and the FACS Lyric flow cytometer in a multicenter study. METHODS A total of 91 samples were used for the validation of the AQUOIS STEM system, including an analytical performance evaluation by means of assessing precision, sample stability, intersample carryover, and linearity and a method comparison with the present FACS systems in use to assess analytical and clinical decision agreement. RESULTS Results showed excellent precision, with coefficient of variations <15% for dedicated quality control material and patient samples. There was no significant carry over. The fresh apheresis samples were stable when stored overnight at room temperature and at 4°C. Analytical comparison with the current systems demonstrated good correlation in peripheral blood, and minimal, clinically neglectable systematic and proportional bias in fresh apheresis products but a low correlation coefficient in cryopreserved products. CONCLUSIONS The STEM system on AQUIOS CL allows automated enumeration of CD34+ stem cells, demonstrating good analytical performance and promising overall outcomes in peripheral blood and fresh apheresis products.
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Affiliation(s)
- Kim Callebaut
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Eva Gijbels
- Department of Laboratory Medicine, AZ Sint-Jan Hospital Brugge, Brugge, Belgium
| | - Jonathan Vanbesien
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
| | - Dries Deeren
- AZ Delta Clinical Haematology, AZ Delta General Hospital, Roeselare, Belgium
| | | | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospital Brugge, Brugge, Belgium
| | - Elisabeth Moreau
- AZ Delta Medical Laboratories, AZ Delta General Hospital, Roeselare, Belgium
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Jung C, Bernhard M. [Monitoring of cardiovascular emergencies in the emergency department]. Dtsch Med Wochenschr 2024; 149:1034-1038. [PMID: 39146751 DOI: 10.1055/a-2105-9849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
In the emergency department, patients with potential or confirmed cardiovascular diseases constitute a significant portion of the overall patient population. Monitoring for cardiovascular surveillance of these patients, until and during the diagnostics and acute therapy often presents an interdisciplinary and interprofessional challenge. This is partly due to the limited number of monitoring spaces in emergency departments. Therefore, it is crucial to establish a differentiated indication for cardiovascular monitoring. Despite limited monitoring resources, ensuring high patient safety is paramount. The correct approach holds significant prognostic importance. For patients requiring extended monitoring, especially using invasive systems, close personnel monitoring is essential, in addition to appropriate staffing and medical equipment. The overarching goal for such patients is to ensure prompt transfer to a suitable destination unit. The provision of an intensive care bed for further care within one hour is aimed for according to the directive of the Federal Joint Committee on staged emergency care in hospitals. Often, at the beginning of the emergency department visit, a definitive diagnosis is not yet established - this is addressed accordingly with symptom-oriented considerations. The present review article focuses on the practical Implementation and modalities of monitoring, as well as its application in a selection of cardiovascular diagnoses in the emergency department.
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Affiliation(s)
- Christian Jung
- Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Cardiovascular Research Institute Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf
| | - Michael Bernhard
- Zentrale Notaufnahme, Universitatsklinikum Düsseldorf, Düsseldorf, Germany
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Ran L, Peng Y, Zhao M, Luo X, Chen S, Tang X, Zhang Y, Li L, Li L, Zhang W, Jiang T, Wu X, Hu R, Liu Y, Yang Z. Predictive model of the efficiency of hematopoietic stem cell collection in patients with multiple myeloma and lymphoma based on multiple peripheral blood markers. Int J Lab Hematol 2024. [PMID: 38960878 DOI: 10.1111/ijlh.14337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/16/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION Autologous hematopoietic stem cell transplantation (ASCT) has gained extensive application in the treatment of lymphoma and multiple myeloma (MM). Plenty of studies demonstrate that peripheral blood indicators could be considered potential predictive biomarkers for hematopoietic stem cells (HSCs) collection efficiency, including white blood cell count (WBC), monocyte count (Mono), platelet count (PLT), hematocrit, and hemoglobin levels. Currently, clinically practical predictive models based on these peripheral detection indicators to quickly, conveniently, and accurately predict collection efficiency are lacking. METHODS In total, 139 patients with MM and lymphoma undergoing mobilization and collection of ASCT were retrospectively studied. The study endpoint was successful collection of autologous HSCs. We analyzed the effects of clinical characteristics and peripheral blood markers on collection success, and screened variables to establish a prediction model. We determined the optimal cutoff value of peripheral blood markers for predicting successful stem cell collection and the clinical value of a multi-marker prediction approach. We also established a prediction model for collection efficacy. RESULTS Univariate and multivariate logistic regression analyses showed that the mobilization regimen, Mono, PLT, mononuclear cell count (MNC), and peripheral blood CD34+ cell count (PB CD34+ counts) were significant predictors of successful collection of peripheral blood stem cells (PBSC). Two predictive models were constructed based on the results of multivariate logistic analyses. Model 1 included the mobilization regimen, Mono, PLT, and MNC, whereas Model 2 included the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts. Receiver operating characteristic (ROC) curve analysis showed that the PB CD34+ counts, Model 1, and Model 2 could predict successful HSCs collection, with cutoff values of 26.92 × 106/L, 0.548, and 0.355, respectively. Model 1 could predict successful HSCs collection with a sensitivity of 84.62%, specificity of 75.73%, and area under the curve (AUC) of 0.863. Model 2 could predict successful HSCs collection with a sensitivity of 83.52%, specificity of 94.17%, and AUC of 0.946; thus, it was superior to the PB CD34+ counts alone. CONCLUSION Our findings suggest that the combination of the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts before collection has predictive value for the efficacy of autologous HSCs collection in patients with MM and lymphoma. Using models based on these predictive markers may help to avoid over-collection and improve patient outcomes.
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Affiliation(s)
- Longrong Ran
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yu Peng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Mingyu Zhao
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Xin Luo
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Shuang Chen
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Xinyi Tang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
- School of Medicine Chongqing University, Chongqing, China
| | - Yakun Zhang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
- School of Medicine Chongqing University, Chongqing, China
| | - Lian Li
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Liangmei Li
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Wei Zhang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Tingting Jiang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Xuelian Wu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Renzhi Hu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yao Liu
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Zailin Yang
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing, China
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Matos DM. "Protein-resistant vanishing counting bead" phenomenon: a new problem with single-platforms for CD34 + quantification? Cytotherapy 2024; 26:649-651. [PMID: 38456855 DOI: 10.1016/j.jcyt.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Daniel Mazza Matos
- Flow Cytometry Section, Cell Processing Center (CPC), Center of Hematology and Hemotherapy of Ceará (HEMOCE), Fortaleza, Ceará, Brazil.
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Mulder AHL, Eidhof HHM, Gratama JW. External quality assessment of flow cytometric bronchoalveolar lavage cellular analysis: 20 years' experience in The Netherlands. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:451-457. [PMID: 36070226 DOI: 10.1002/cyto.b.22090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/28/2022] [Accepted: 08/23/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bronchoalveolar (BAL) cellular analysis can be supportive in the diagnosis of interstitial lung disease. The flow cytometric analysis of BAL fluid cells is complicated by cell fragility and adherence and autofluorescence of macrophages, making conventional analysis of BAL fluid cells as done in external quality schemes (EQA) for blood lymphocyte subsets, not representative. Following a procedure for stabilized BAL cells, a separate EQA was set up. The results of 20 years' experience are presented. METHODS From each round between 2000 and 2020 the following flow cytometric parameters were recorded from each participant: total lymphocyte population (TLY), CD3+ lymphocytes, CD3+ CD4+ lymphocytes, CD3+ CD8+ lymphocytes, CD3- CD16+/56+ lymphocytes, CD19+ lymphocytes and CD103 + CD3+ lymphocytes. In addition, the eosinophils and neutrophils were recorded. The mean and standard deviation of each parameter per round were calculated. The 40 rounds were divided in four respective groups of 10 in order to compare the results as function of time. In addition the interpretation of the results of participants was scored. RESULTS The median SD in the four groups was below 10% for all parameters except for TLY and the CD103+ CD3+ lymphocytes. No improvement in time was observed for any (sub)population except for the CD3+ CD4+ subset. Interpretation of the results varied based on disease, with greatest consensus for sarcoidosis cases and lowest for nonspecific interstitial lung disease cases. CONCLUSIONS A dedicated EQA for BAL fluid cellular analysis appears to be justified as the test material is substantially different from that of peripheral blood. We show that adequate analytical and post-analytical quality control can be achieved.
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Affiliation(s)
- A H Leontine Mulder
- Medlon B.V., Department of Clinical Chemistry and Laboratory Medicine, Enschede and Clinical Chemistry, Ziekenhuis Groep Twente, Almelo, The Netherlands
| | - Harrie H M Eidhof
- Medlon B.V., Department of Clinical Chemistry and Laboratory Medicine, Ziekenhuis Groep Twente, Enschede, The Netherlands
| | - Jan W Gratama
- Department of Medical Oncology, Erasmus MC, Rotterdam, The Netherlands
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Vladimira R, Ines B. Role of flow cytometry in evaluation of the cellular therapy products used in haematopoietic stem cell transplantation. Int J Lab Hematol 2022; 44:446-453. [PMID: 35419954 DOI: 10.1111/ijlh.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 11/26/2022]
Abstract
Cellular therapy nowadays includes various products from haematopoietic stem cells (HSC) collected from bone marrow, peripheral blood, and umbilical cord blood to more complex adoptive immune therapy for the treatment of malignant diseases, and gene therapy for inherited immune deficiencies. Broader utilization of cellular therapy requires extensive quality testing of these products that should fulfil the same requirements regarding composition, purity, and potency nevertheless they are manufactured in various centres. Technical improvements of the flow cytometers accompanied by the increased number of available reagents and fluorochromes used to conjugate monoclonal antibodies, enable detailed and precise insight into the function of the immune system and other areas of cell biology, and allows cell evaluation based on size, shape, and morphology or assessment of cell surface markers, as well as cell purity and viability, which greatly contributes to the development and progress of the cell therapy. The aim of this paper is to give an overview of the current use and challenges of flow cytometry analysis in quality assessment of cellular therapy products, with regard to basic principles of determining HSC and leukocyte subpopulation, assessment of cells viability and quality of thawed cryopreserved HSC as well as the importance of validation and quality control of flow cytometry methods according to good laboratory practice.
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Affiliation(s)
- Rimac Vladimira
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Bojanić Ines
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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Al Mamari S, Al Saadi A, Al Zaabi R, Al Jamalani A, Al Qassabi J, Pathare A, Al-Khabori M. Measurement of hematopoietic progenitor cells using XN2000 hematology analyzer. Int J Lab Hematol 2021; 44:82-87. [PMID: 34409726 DOI: 10.1111/ijlh.13683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Stem cell enumeration by the hematopoietic progenitor cells (HPC) mode is a novel method available from Sysmex XN2000 hematology analyzer. A small amount of blood (190 μL) is required, and the results are available in a few minutes without manual gating or presample treatment. The present study compares stem cell measurements using XN2000 analyzer HPC mode and FC500 flow cytometry analyzer using peripheral blood (PB) specimens and apheresis products. METHODS In this prospective study, CD34-positive cell counts were enumerated using an FC500 flow cytometry analyzer and compared with XN2000 Sysmex analyzer (XN-HPC mode) in the same samples. Results were compared using Bland-Altman plots. RESULTS A total of 103 samples were used. In the PB samples, the median HPC count and CD34-positive cells were 83.5 × 106 /L and 78.0 × 106 /L, respectively. The mean Bland-Altman difference was 4.5 × 106 /L (Limits: -51.7 to 60.7 × 106 /L), with a Pearson's correlation of 0.79. In the apheresis products, the median HPC count and CD34-positive cells were 1468 × 106 /L (IQR: 1049 - 1960 × 106 /L) and 1327 × 106 /L (IQR: 910 - 2001 × 106 /L), respectively. The mean Bland-Altman difference was 179.0 × 106 /L (Limits: -2022.2 - 2380.2 × 106 /L), with a Pearson's correlation of 0.58. CONCLUSION The XN-HPC mode has an excellent correlation and minimal disagreement for stem cell enumeration in PB compared with flow cytometry and could replace it. There is high disagreement in apheresis products, and therefore, the XN-HPC mode cannot be recommended.
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Lysak D, Brychtová M, Leba M, Čedíková M, Georgiev D, Jindra P, Vlas T, Holubova M. Long-Term Cryopreservation Does Not Affect Quality of Peripheral Blood Stem Cell Grafts: A Comparative Study of Native, Short-Term and Long-Term Cryopreserved Haematopoietic Stem Cells. Cell Transplant 2021; 30:9636897211036004. [PMID: 34328022 PMCID: PMC8327011 DOI: 10.1177/09636897211036004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cryopreserved haematopoietic progenitor cells are used to restore autologous haematopoiesis after high dose chemotherapy. Although the cells are routinely stored for a long period, concerns remain about the maximum storage time and the possible negative effect of storage on their potency. We evaluated the effect of cryopreservation on the quality of peripheral stem cell grafts stored for a short (3 months) and a long (10 years) period and we compared it to native products.The viability of CD34+ cells remained unaffected during storage, the apoptotic cells were represented up to 10% and did not differ between groups. The clonogenic activity measured by ATP production has decreased with the length of storage (ATP/cell 1.28 nM in native vs. 0.63 in long term stored products, P < 0.05). Only borderline changes without statistical significance were detected when examining mitochondrial and aldehyde dehydrogenase metabolic activity and intracellular pH, showing their good preservation during cell storage. Our experience demonstrates that cryostorage has no major negative effect on stem cell quality and potency, and therefore autologous stem cells can be stored safely for an extended period of at least 10 years. On the other hand, long term storage for 10 years and longer may lead to mild reduction of clonogenic capacity. When a sufficient dose of stem cells is infused, these changes will not have a clinical impact. However, in products stored beyond 10 years, especially when a low number of CD34+ cells is available, the quality of stem cell graft should be verified before infusion using the appropriate potency assays.
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Affiliation(s)
- Daniel Lysak
- Department of Haematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Michaela Brychtová
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Martin Leba
- New Technologies for the Information Society European Centre of Excellence, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Miroslava Čedíková
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - Daniel Georgiev
- New Technologies for the Information Society European Centre of Excellence, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Pavel Jindra
- Department of Haematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Tomáš Vlas
- Institute of Immunology and Allergology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Monika Holubova
- Department of Haematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
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Pedrosa de Lira de Morais CC, Dias Alves Pinto J, Wagner de Souza K, Izu M, Fernando da Silva Bouzas L, Henrique Paraguassú-Braga F. Validation of the single-platform ISHAGE protocol for enumeration of CD34+ hematopoietic stem cells in umbilical cord blood in a Brazilian center. Hematol Transfus Cell Ther 2020; 44:49-55. [PMID: 33358615 PMCID: PMC8885393 DOI: 10.1016/j.htct.2020.09.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 11/21/2022] Open
Abstract
Background This study aims to validate the single-platform method for enumeration of CD34+ cells, by comparing the performance of two different commercial kits, as well as to evaluate the efficiency of the AccuriTM C6 cytometer in providing direct counts of absolute cell numbers. Method We evaluated 20 samples from umbilical cord blood (UCB), comparing the two different methodologies for enumeration of CD34+ cells: single and dual-platform. For the assessment of the single-platform, Procount and SCE kits were used, both of which use fluorescent beads as a counting reference to obtain absolute CD34+ cells numbers. Moreover, after the acquisition of samples in flow cytometer AccuriTM C6, following the protocol established for each kit, the number of CD34+ cells was recalculated, considering the cell count provided by the AccuriTM C6. Main Results In our analysis, the results showed a strong correlation between the number of CD34+ cells/μL (r2 = 0.77) when comparing the SCE kit and the current dual-platform method. On the other hand, the comparison between Procount kit and dual-platform results showed a moderate correlation for the number of CD34+/μL cells (r2 = 0.64). Conclusion Our results showed that the AccuriTM C6 flow cytometer can be used safely, applying both the dual and single platform analysis strategy. Considering the ISHAGE protocol-based single-platform approach, as the most appropriate methodology for CD34+ cells enumeration, our results demonstrated that the SCE kit has great potential for national standardization of UCB samples analysis methodology.
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Affiliation(s)
| | | | | | - Marina Izu
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
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Kalina T. Reproducibility of Flow Cytometry Through Standardization: Opportunities and Challenges. Cytometry A 2019; 97:137-147. [DOI: 10.1002/cyto.a.23901] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Tomas Kalina
- CLIP‐Childhood Leukemia Investigation Prague, Department of Pediatric Hematology and Oncology2nd Medical School, Charles University and University Hospital Motol Prague Czech Republic
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Cooling L, Roxbury K, Hoffmann S, DeBusscher J, Kota U, Goldstein S, Davenport R. Use of allogeneic apheresis stem cell products as an interlaboratory proficiency challenge. Transfusion 2017; 57:1543-1554. [PMID: 28370131 DOI: 10.1111/trf.14107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/02/2017] [Accepted: 02/07/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND AABB Standards requires that laboratories participate in a proficiency test (PT) program for critical analytes. Institutions can purchase commercial PT materials; however, PT can also be performed through interlaboratory exchange. We investigated the utility of allogeneic hematopoietic progenitor cell apheresis (HPC-A) products as an interlaboratory PT challenge for total nucleated cell count (TNC) and CD34 assessment. STUDY DESIGN AND METHODS Three-year retrospective and comparative review of unrelated allogeneic HPC-A products received by the University of Michigan between January 2011 and December 2013. Internal TNC and CD34 count were compared to the external collecting facility by paired t test and linear regression. The absolute and percent difference between external and internal counts and 95% limits of agreeability (95% LA) were determined. Results were analyzed relative to donor center location (international, domestic), time zone (domestic), and calendar year. RESULTS There was a strong correlation between internal and external TNC, regardless of donor center location or year. For CD34, there was a good correlation between centers (R = 0.88-0.91; slope = 0.95-0.98x) with a median difference of -1% (95% LA, -50%, +47%). This was considerably better than commercial PT challenges, which showed a persistent negative bias for absolute CD34 and CD3 counts. CONCLUSION Allogeneic HPC-A products represent an interlaboratory PT exchange for all critical analytes, including TNC and CD34 count, cell viability, and sterility. Allogeneic HPC-A products, which are fresh and transported under validated conditions, are less subject to preanalytical variables that may impact commercial PT samples such as aliquoting and sample homogeneity, commercial additives, and sample stability during manufacturing and transport.
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Affiliation(s)
- Laura Cooling
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Kelly Roxbury
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Sandra Hoffmann
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Joan DeBusscher
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Usha Kota
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Steven Goldstein
- Department of Internal Medicine, Division of Hematology/Oncology and Blood and Marrow Transplant Program, University of Michigan, Ann Arbor, Michigan.,Bone Marrow Transplant Program, Florida Hospital Cancer Institute, Orlando, Florida
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Liu Y. [The guidelines for absolute count of CD34⁺ cell determination by flow cytometry]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:539-46. [PMID: 26304073 PMCID: PMC7342635 DOI: 10.3760/cma.j.issn.0253-2727.2015.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Preijers FWMB, van der Velden VHJ, Preijers T, Brooimans RA, Marijt E, Homburg C, van Montfort K, Gratama JW. Fifteen years of external quality assessment in leukemia/lymphoma immunophenotyping in The Netherlands and Belgium: A way forward. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:267-78. [PMID: 26102096 DOI: 10.1002/cyto.b.21266] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 06/19/2015] [Indexed: 11/06/2022]
Abstract
In 1985, external quality assurance was initiated in the Netherlands to reduce the between-laboratory variability of leukemia/lymphoma immunophenotyping and to improve diagnostic conclusions. This program consisted of regular distributions of test samples followed by biannual plenary participant meetings in which results were presented and discussed. A scoring system was developed in which the quality of results was rated by systematically reviewing the pre-analytical, analytical, and post-analytical assay stages using three scores, i.e., correct (A), minor fault (B), and major fault (C). Here, we report on 90 consecutive samples distributed to 40-61 participating laboratories between 1998 and 2012. Most samples contained >20% aberrant cells, mainly selected from mature lymphoid malignancies (B or T cell) and acute leukemias (myeloid or lymphoblastic). In 2002, minimally required monoclonal antibody (mAb) panels were introduced, whilst methodological guidelines for all three assay stages were implemented. Retrospectively, we divided the study into subsequent periods of 4 ("initial"), 4 ("learning"), and 7 years ("consolidation") to detect "learning effects." Uni- and multivariate models showed that analytical performance declined since 2002, but that post-analytical performance improved during the entire period. These results emphasized the need to improve technical aspects of the assay, and reflected improved interpretational skills of the participants. A strong effect of participant affiliation in all three assay stages was observed: laboratories in academic and large peripheral hospitals performed significantly better than those in small hospitals. © 2015 International Clinical Cytometry Society.
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Affiliation(s)
- Frank W M B Preijers
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud UMC, Nijmegen, The Netherlands
| | | | - Tim Preijers
- Laboratory of Hematology, Department of Laboratory Medicine, Radboud UMC, Nijmegen, The Netherlands
| | - Rik A Brooimans
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erik Marijt
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Christa Homburg
- Department of Immunocytology, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Kees van Montfort
- Department of Trials and Statistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan W Gratama
- Department of Internal Oncology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Dhakal B, Strouse C, D'Souza A, Arce-Lara C, Esselman J, Eastwood D, Pasquini M, Saber W, Drobyski W, Rizzo JD, Hari PN, Hamadani M. Plerixafor and Abbreviated-Course Granulocyte Colony–Stimulating Factor for Mobilizing Hematopoietic Progenitor Cells in Light Chain Amyloidosis. Biol Blood Marrow Transplant 2014; 20:1926-31. [DOI: 10.1016/j.bbmt.2014.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 08/04/2014] [Indexed: 01/04/2023]
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15
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Kalina T, Flores-Montero J, Lecrevisse Q, Pedreira CE, van der Velden VHJ, Novakova M, Mejstrikova E, Hrusak O, Böttcher S, Karsch D, Sędek Ł, Trinquand A, Boeckx N, Caetano J, Asnafi V, Lucio P, Lima M, Helena Santos A, Bonaccorso P, van der Sluijs-Gelling AJ, Langerak AW, Martin-Ayuso M, Szczepański T, van Dongen JJM, Orfao A. Quality assessment program for EuroFlow protocols: Summary results of four-year (2010-2013) quality assurance rounds. Cytometry A 2014; 87:145-56. [DOI: 10.1002/cyto.a.22581] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/28/2014] [Accepted: 10/06/2014] [Indexed: 01/21/2023]
Affiliation(s)
- Tomas Kalina
- CLIP - Childhood Leukemia Investigation Prague and Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine; Charles University Prague and University Hospital Motol; Prague Czech Republic
| | - Juan Flores-Montero
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Servicio General de Citometria (NUCLEUS) and Department of Medicine; University of Salamanca; Salamanca Spain
| | - Quentin Lecrevisse
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Servicio General de Citometria (NUCLEUS) and Department of Medicine; University of Salamanca; Salamanca Spain
| | - Carlos E. Pedreira
- Systems & Computing Department (PESC), COPPE - Engineering Graduate Program; Federal University of Rio de Janeiro; Rio de Janeiro (UFRJ) Brazil
| | | | - Michaela Novakova
- CLIP - Childhood Leukemia Investigation Prague and Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine; Charles University Prague and University Hospital Motol; Prague Czech Republic
| | - Ester Mejstrikova
- CLIP - Childhood Leukemia Investigation Prague and Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine; Charles University Prague and University Hospital Motol; Prague Czech Republic
| | - Ondrej Hrusak
- CLIP - Childhood Leukemia Investigation Prague and Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine; Charles University Prague and University Hospital Motol; Prague Czech Republic
| | - Sebastian Böttcher
- Second Department of Medicine; University Hospital of Schleswig-Holstein; Campus Kiel Kiel Germany
| | - Dennis Karsch
- Second Department of Medicine; University Hospital of Schleswig-Holstein; Campus Kiel Kiel Germany
| | - Łukasz Sędek
- Department of Pediatric Hematology and Oncology; Zabrze Medical University of Silesia; Katowice Poland
| | - Amelie Trinquand
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut national de recherche médicale (INSERM) U1151, and Laboratory of Onco-Hematology; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades Paris France
| | - Nancy Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven and Department of Oncology; Catholic University Leuven; Leuven Belgium
| | - Joana Caetano
- Hemato-Oncology Laboratory, Department of Hematology; Portuguese Institute of Oncology (IPOLFG); Lisbon Portugal
| | - Vahid Asnafi
- Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut national de recherche médicale (INSERM) U1151, and Laboratory of Onco-Hematology; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades Paris France
| | - Paulo Lucio
- Hemato-Oncology Laboratory, Department of Hematology; Portuguese Institute of Oncology (IPOLFG); Lisbon Portugal
| | - Margarida Lima
- Laboratory of Flow Cytometry, Department of Hematology; Hospital de Santo António, Centro Hospitalar do Porto; Porto Portugal
| | - Ana Helena Santos
- Laboratory of Flow Cytometry, Department of Hematology; Hospital de Santo António, Centro Hospitalar do Porto; Porto Portugal
| | - Paola Bonaccorso
- M.Tettamanti Research Center, Pediatric Clinic University of Milan Bicocca; Monza Italy
| | | | - Anton W. Langerak
- Department of Immunology; Erasmus MC University Medical Center; Rotterdam Netherlands
| | | | - Tomasz Szczepański
- Department of Pediatric Hematology and Oncology; Zabrze Medical University of Silesia; Katowice Poland
| | | | - Alberto Orfao
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Servicio General de Citometria (NUCLEUS) and Department of Medicine; University of Salamanca; Salamanca Spain
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Use of Laboratory Tests to Guide Initiation of Autologous Hematopoietic Progenitor Cell Collection by Apheresis: Results From the Multicenter Hematopoietic Progenitor Cell Collection by Apheresis Laboratory Trigger Survey. Transfus Med Rev 2014; 28:198-204. [DOI: 10.1016/j.tmrv.2014.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/25/2014] [Accepted: 08/05/2014] [Indexed: 11/21/2022]
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Enumeration of circulating fibrocytes for clinical use in asthma by an optimized single-platform flow cytometry assay. BBA CLINICAL 2014; 1:52-8. [PMID: 26673636 PMCID: PMC4633918 DOI: 10.1016/j.bbacli.2014.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/04/2014] [Accepted: 06/09/2014] [Indexed: 11/23/2022]
Abstract
Background Elevated numbers of circulating fibrocytes are associated with inadequately controlled asthma, poor response to available therapies, and increased risk of adverse outcomes. The lack of reliable and clinically-applicable assays precludes a proper evaluation of blood fibrocyte count as a prognostic biomarker in asthma. This report concerns the use of a multiparameter flow cytometry assay for the enumeration of fibrocytes in the whole blood. Methods Consenting fibrocyte donors were 19 patients with asthma well controlled by current treatment, 16 patients with treatment-resistant asthma, 9 patients with transiently uncontrolled asthma and 14 age-matched normal individuals. Blood sampling was performed once in patients with transiently uncontrolled asthma and twice, at an interval of one week, in the other subjects. The assay was performed in 100 μl of whole blood and involved a sequential gating strategy and absolute fibrocyte counting with a single instrument (single-platform assay). Results The quantification of circulating fibrocytes by this assay was analytically and clinically valid. In individuals with stable clinical conditions, the repeatability of blood fibrocyte counts over one week was good. The intraclass correlation coefficient was 0.939 and 96.88% of the total variability reflected on-average differences among the tested subjects. Stabilized blood samples could be stored at 4 °C for up to 96 h before processing. Conclusions The novel assay for the enumeration of fibrocytes in the whole blood is reliable and clinically applicable. General significance This report demonstrates the validity and reliability of the first optimized assay for the enumeration of circulating fibrocytes in multicenter clinical trials. Elevated blood fibrocyte count is an emerging prognostic biomarker in asthma. The lack of reliable, clinically-applicable assays precludes further evaluation. An optimized whole-blood single-platform flow cytometry assay is described here. The assay is analytically and clinically valid and provides reproducible measures. Stabilized blood samples can be stored for 96 h at 4 °C before processing.
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Key Words
- 7-AAD, 7-amino-actinomycin-D
- AF, Alexa Fluor
- Asthma
- BMC, blood mononuclear cell
- Biomarker
- CCC, concordance correlation coefficient
- CI, confidence interval
- COL1, type I collagen
- CT, threshold cycle
- Clinical outcome
- ET-1, endothelin-1
- FSC, forward scatter
- Fibrocyte enumeration
- Flow cytometry
- ICC, intraclass correlation coefficient
- MFI, mean fluorescence intensity
- PB, Pacific Blue
- SD, standard deviation
- SS, sum of squares
- SSC, side scatter
- Single-platform assay
- α-SMA, α-smooth muscle actin
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Gustafson MP, Lin Y, Ryder M, Dietz AB. Strategies for improving the reporting of human immunophenotypes by flow cytometry. J Immunother Cancer 2014; 2:18. [PMID: 24982762 PMCID: PMC4075421 DOI: 10.1186/2051-1426-2-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 05/07/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Flow cytometry is the gold standard for phenotyping and quantifying immune cells. New technologies have greatly increased our capacity to measure both routine and complex immunophenotypes. The reporting of immunophenotype data is not consistent in human studies yet it is quite critical for understanding disease specific changes, responses to immunotherapies, and normal immune homeostasis. Here we examine the barriers that hinder cross comparisons of flow cytometry data collected from human studies and clinical trials. FINDINGS We demonstrate that phenotypes reported as percentages within a cell compartment (i.e. myeloid derived suppressor cells as a percent of mononuclear cells) without providing data on the parent population may contribute to misleading conclusions. The enumeration of phenotypes as cell counts (cells/μl) provides a basis to more accurately compare the relationships among phenotypes. Finally, we provide evidence that density gradient centrifugation, which eliminates the ability to measure phenotypes as cell counts, can affect the expression of surface markers and consequently alter the distribution of particular immunophenotypes. CONCLUSIONS We propose that by measuring immunophenotypes as cell counts from minimally manipulated samples (whole blood) will improve the reporting of flow data and facilitate more direct comparisons of data across human studies.
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Affiliation(s)
- Michael P Gustafson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA
| | - Yi Lin
- Division of Hematology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA
| | - Mabel Ryder
- Division of Endocrinology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA
| | - Allan B Dietz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA
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Defining consensus leukemia-associated immunophenotypes for detection of minimal residual disease in acute myeloid leukemia in a multicenter setting. Blood Cancer J 2013; 3:e129. [PMID: 23912609 PMCID: PMC3763381 DOI: 10.1038/bcj.2013.27] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 06/25/2013] [Indexed: 11/29/2022] Open
Abstract
Flow-cytometric detection of minimal residual disease (MRD) has proven in several single-institute studies to have an independent prognostic impact. We studied whether this relatively complex approach could be performed in a multicenter clinical setting. Five centers developed common protocols to accurately define leukemia-associated (immuno)phenotypes (LAPs) at diagnosis required to establish MRD during/after treatment. List mode data files were exchanged, and LAPs were designed by each center. One center, with extensive MRD experience, served as the reference center and coordinator. In quarterly meetings, consensus LAPs were defined, with the performance of centers compared with these. In a learning (29 patients) and a test phase (35 patients), a mean of 2.2 aberrancies/patient was detected, and only 1/63 patients (1.6%) had no consensus LAP(s). For the four centers without (extensive) MRD experience, clear improvement could be shown: in the learning phase, 39–63% of all consensus LAPs were missed, resulting in a median 30% of patients (range 21–33%) for whom no consensus LAP was reported; in the test phase, 27–40% missed consensus LAPs, resulting in a median 16% (range 7–18%) of ‘missed' patients. The quality of LAPs was extensively described. Immunophenotypic MRD assessment in its current setting needs extensive experience and should be limited to experienced centers.
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Rollins-Raval MA, Fisher J, Craig FE. Monoclonal B lymphocytosis versus chronic lymphocytic leukemia: Factors affecting implementation of an absolute threshold. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:149-56. [DOI: 10.1002/cyto.b.21077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 11/28/2012] [Accepted: 01/07/2013] [Indexed: 11/12/2022]
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21
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Lysák D, Merglová L, Navrátilová J, Svoboda T, Jindra P, Koza V. CD34⁺ cell content in unrelated allogeneic peripheral blood stem cell grafts transported internationally. Does the inter-laboratory variability affect comparability of graft quality data? Transfus Apher Sci 2012; 47:179-84. [PMID: 22842107 DOI: 10.1016/j.transci.2012.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 06/29/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Increasing numbers of unrelated hematopoietic stem cell grafts are transported internationally and evaluated concurrently in different laboratories. The graft quality assessment using the CD34(+) enumeration could be influenced by inter-laboratory variability. METHODS We retrospectively analyzed the content of CD34(+) cells in 154 consecutive collections being performed in different transplant centers during two periods (2003-2004, 2007-2010). All samples were tested twice in our own and partner laboratories. CD34(+) percentage and absolute number were compared. RESULTS The percentage and the total CD34(+) content correlated well in both observed periods (CD34(+)%: r=0.899 and r=0.922; CD34(+)×10(8)/kg: r=0.966 and r=0.880; p<0.0001). Median CD34(+) percentages obtained in our centre in comparison with other laboratories were 0.54% vs. 0.46% in 2003-2004 and 0.69% vs. 0.70% in 2007-2010 period. The degree of laboratory compliance was affected by the laboratory identity. CD34(+) percentage reported by one laboratory and CD34(+)×10(8)/kg reported by three from twelve laboratories lacked statistically significant correlation with our own data. CONCLUSIONS The study documented that results of CD34(+) cell dose assessment of the same grafts reported by different transplant centers are comparable. The graft quality data and the CD34(+) enumeration possess a limited level of inter-laboratory variability.
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Affiliation(s)
- D Lysák
- Charles University in Prague, Faculty of Medicine in Pilsen, Czech Republic.
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Gutensohn K, Nikolitsis A, Gramatzki M, Spitzer D, Buwitt-Beckmann U, Humpe A. Direct volumetric flow cytometric quantitation of CD34+ stem and progenitor cells. Transfus Med 2012; 22:205-10. [PMID: 22519551 DOI: 10.1111/j.1365-3148.2012.01155.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In this study, we compared a classic single-platform (SP) method applying beads for enumeration of CD45+ or CD34+ cells with a new device allowing direct volumetric measurements of stem and progenitor cells. BACKGROUND Following apheresis and cyropreservation, the precise enumeration of CD34+ cells as key parameter of graft quality is mandatory for the clinical course after transplantation. Currently, flow cytometry with SP technique represents the 'gold standard' for such determinations. METHODS/MATERIALS Fresh samples, 14 from mobilised peripheral blood (PB), 9 from apheresis products (AP) and 13 samples from frozen-thawed (FT) haematopoietic progenitor cell grafts, were analysed for CD34+ cells, CD45+ cells, and in frozen-thawed samples for viability by a bead-based flow cytometric method and in parallel by a direct, volumetric flow cytometric method. RESULTS Comparison of CD34+ analyses revealed a significant correlation (P < 0·01) for each material between both techniques with r = 0·95 (PB), r = 0·933 (AP) and r = 0·929 (FT). Also, for analysis of CD45+ cells µL(-1) , the measured numbers evaluated with the different techniques did not significantly differ for all three materials analysed. In frozen-thawed samples, the analysis of viability was comparable for both techniques. CONCLUSIONS The results of this study demonstrate that a direct volumetric analysis of CD34+ cells µL(-1) or CD45+ cells µL(-1) is feasible. This technique represents a simple and economical approach for standardisation of progenitor and stem cell analyses.
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Affiliation(s)
- K Gutensohn
- Institute for Transfusion Medicine, University Hospital Hamburg-Eppendorf, Germany.
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Azouna NB, Berraeis L, Regaya Z, Jenhani F. Immunophenotyping of hematopoietic progenitor cells: Comparison between cord blood and adult mobilized blood grafts. World J Stem Cells 2011; 3:104-12. [PMID: 22180831 PMCID: PMC3240678 DOI: 10.4252/wjsc.v3.i11.104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/30/2011] [Accepted: 10/05/2011] [Indexed: 02/06/2023] Open
Abstract
AIM To study the immunophenotype of hematopoietic progenitor cells from cord blood (CB) grafts (n = 39) in comparison with adult apheresis grafts (AG, n = 229) and pre-apheresis peripheral blood (PAPB) samples (n = 908) using flow cytometry analysis. METHODS First, we performed a qualitative analysis of CD34+ cell sub-populations in both CB and PAPB grafts using the standardized ISHAGE protocol and a wide panel of 20 monoclonal antibodies. Next, we studied some parameters, such as the age of mothers and the weight of newborns, which can influence the quality and the quantity of CD34+ cells from CB. RESULTS We found that the percentage of apoptotic cells was high in CB in comparison to PAPB (PAPB: 4.6% ± 2.6% vs CB: 53.4% ± 5.2%, P < 0.001). In CB, the weight of newborn and the age of the mother have the influence on CD34+ cells. The follow-up of Ag CD133 in the ISHAGE double platform protocol in association with CD45, CD34 and the 7'AAD shows an equal rate between the two cell populations CD133+CD45+CD34+ high and CD34+CD45+ high with a higher percentage. So, is the inclusion of Ac CD133 necessary in the present panel included in the ISHAGE method? Last part, we showed a significant presence of interferon γ in CB in comparison to PAPB, the annexin showing the high number of apoptotic cells in CB. CONCLUSION This study demonstrates that many different obstetric factors must be taken into account when processing and cryo-banking umbilical CB units for transplantation.
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Affiliation(s)
- Nesrine Ben Azouna
- Nesrine Ben Azouna, Faouzi Jenhani, Immunology Research Unit, Faculty of Pharmacy of Monastir, Monsatir University, TU-5000 Monastir, Tunisia
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Eidenschink L, DiZerega G, Rodgers K, Bartlett M, Wells DA, Loken MR. Basal levels of CD34 positive cells in peripheral blood differ between individuals and are stable for 18 months. CYTOMETRY PART B-CLINICAL CYTOMETRY 2011; 82:18-25. [PMID: 21812106 DOI: 10.1002/cyto.b.20611] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 06/16/2011] [Accepted: 06/30/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Detection of basal levels of CD34 progenitor cells is a rare event analysis enumerating cells down to 1 cell/μl. A reproducible analytic approach was used in three independent clinical trials in which multiple sequential assays were obtained from the same individual. METHODS A 4 color panel combining, HLA-DR, CD34, CD45, and CD11b was used in a dual platform analysis to quantify CD34 progenitor cells in peripheral blood, with quality control focused at the lowest measurements (i.e., basal levels), where assay error is greatest. RESULTS Repeat testing of individuals every 4 h over the course of 6 days provided a unique opportunity to assess the precision of the analytic technique and identified basal differences between individuals. In a second study, the basal levels were stable for 10 weeks while in a third study the individual differences were maintained for 18 months. This approach was then used to monitor the kinetics of mobilization of CD34 cells following G-CSF stimulation every 4 h. CONCLUSIONS The differences between individuals in basal levels of CD34 were shown to be a biologic constant, stable for 18 months and not a result of the variability of the assay, shown by low coefficients of variation for each individual. These results can be used to augment a quality control program by monitoring individuals over time to establish intra and inter-laboratory assay precision. In addition, the response of six individuals to G-CSF demonstrated differences in absolute numbers of mobilized CD34 progenitor cells but showed identical kinetics, peaking at 80-110 h.
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Gutensohn K, Jessen M, Ketels A, Gramatzki M, Humpe A. Flow cytometric analyses of CD34+ cells with inclusion of internal positive controls. Transfusion 2011; 52:284-90. [DOI: 10.1111/j.1537-2995.2011.03259.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mekouar H, Mullier F, Dinon Q, Bailly N, Cornet Y, Chatelain B. No effect of lysis solutions on absolute CD19+ lymphocytes count and CD45 index in chronic lymphocytic leukemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2011; 80:369-72. [DOI: 10.1002/cyto.b.20604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2010] [Revised: 04/19/2011] [Accepted: 05/03/2011] [Indexed: 11/09/2022]
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Lysák D, Kalina T, Martínek J, Pikalová Z, Vokurková D, Jarešová M, Marinov I, Ondrejková A, Spaček M, Stehlíková O. Interlaboratory variability of CD34+ stem cell enumeration. A pilot study to national external quality assessment within the Czech Republic. Int J Lab Hematol 2011; 32:e229-36. [PMID: 20561093 DOI: 10.1111/j.1751-553x.2010.01244.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We present the results of a pilot study concerning the interlaboratory variability of CD34+ enumeration. Three surveys, each including a set of samples, were sent to participating Czech flow cytometry laboratories. The efficacy of this exercise was determined by the reduction in interlaboratory variation and the influence of method used on assay outcome. The variability in results of CD34+ enumeration declined with time. The mean coefficient of variation (CV) of measurement among laboratories dropped, from 58% in first survey to 32% in last survey. All tested variables (gating strategy, platform methodology, sample preparation) affected the variability of the assay. Sample preparation method was associated with a significant bias of absolute CD34+ cell counts. Initially, the outcome of the measurement was also affected by the participating laboratory (identified by a unique laboratory number; ULN). However, laboratories with poorer performance modified their protocols during the study, and the ULN ceased to influence the variability. This study was successful in reducing the interinstitutional variability of CD34+ enumeration. It was shown that the implementation of a standardized protocol does not guarantee accurate measurement. Our research design represents a useful tool, which allows verification of the proper use of a standardized method, the training of operators and feedback in response to the survey results.
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Affiliation(s)
- Daniel Lysák
- Department of Hematology and Oncology, Charles University Hospital, Pilsen, Czech Republic.
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Green CL, Brown L, Stewart JJ, Xu Y, Litwin V, Mc Closkey TW. Recommendations for the validation of flow cytometric testing during drug development: I instrumentation. J Immunol Methods 2011; 363:104-19. [DOI: 10.1016/j.jim.2010.07.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/12/2010] [Accepted: 07/12/2010] [Indexed: 10/25/2022]
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Kraan J, Sleijfer S, Strijbos MH, Ignatiadis M, Peeters D, Pierga JY, Farace F, Riethdorf S, Fehm T, Zorzino L, Tibbe AGJ, Maestro M, Gisbert-Criado R, Denton G, de Bono JS, Dive C, Foekens JA, Gratama JW. External quality assurance of circulating tumor cell enumeration using the CellSearch(®) system: a feasibility study. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 80:112-8. [PMID: 21337491 DOI: 10.1002/cyto.b.20573] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/24/2010] [Accepted: 08/30/2010] [Indexed: 12/18/2022]
Abstract
BACKGROUND Circulating tumor cells (CTCs) are cells that have detached from solid tumors and entered the blood. CTCs can be detected, among others, by semi-automated immunomagnetic enrichment and image cytometry using CellSearch® (Veridex, Raritan, NJ). We studied the feasibility of external quality assurance (EQA) of the entire CellSearch procedure from blood draw to interpretation of results in multiple laboratories. METHODS Blood samples from six cancer patients and controls were distributed to 14 independent laboratories to test between-laboratory, between-assay, and between-instrument variation. Additionally, between-operator variability was assessed through the interpretation of blinded images of all blood samples on a website. RESULTS Shipment and storage of samples had no influence on CTC values. Between-instrument (coefficient of variation (CV) < 12%) and between-assay variation was low (CV ≤ 20%), indicating high reproducibility. However, between-laboratory CV ranged from 45 to 64%. Although inter-operator agreement on image interpretation (Fleiss' κ statistics) ranged from "substantial" to "almost perfect," image interpretation, particularly of samples containing high numbers of apoptotic cells, was the main contributor to between-laboratory variation. CONCLUSIONS This multicenter study shows the feasibility of an EQA program for CTC detection in patient samples, and the importance of continuation of such a program for the harmonization of CTC enumeration.
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Affiliation(s)
- Jaco Kraan
- Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
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Jaime-Pérez JC, Hernández-Alcántara AE, Méndez-Ramírez N, Vázquez-Garza E, Cantú-Rodríguez OG, Gómez-Almaguer D. Mobilization kinetics of CD133+ hematoprogenitor cells for hematopoietic grafting. Transfusion 2009; 49:532-5. [DOI: 10.1111/j.1537-2995.2008.01979.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Korpi-Steiner NL, Sheerar D, Puffer EB, Urben C, Boyd J, Guadarrama A, Schell K, Denlinger LC. Standardized method to minimize variability in a functional P2X(7) flow cytometric assay for a multi-center clinical trial. CYTOMETRY PART B-CLINICAL CYTOMETRY 2008; 74:319-29. [PMID: 18431793 DOI: 10.1002/cyto.b.20421] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Flow cytometric analysis of human P2X(7) pore activity segregates variant from common P2RX7 genotypes and may serve as a biomarker for cancer, pain, inflammation, and immune responses to infection. Standardization is needed to accommodate variable sample age and instrumentation differences in a multicenter clinical trial. METHODS CD14-PE-stained whole blood samples were treated with YO-PRO-1 combined with a P2X(7) agonist (BzATP) or control, followed by the addition of PI after closure of the P2X(7) pore. Recalled instrument settings from previous publications were used to adapt a standardized fluorescent particle-adjusted set-up method. Experiments were performed to compare the two methods while evaluating components of systematic variability and facilitating reliable processing of samples with varied ages. RESULTS The median YO-PRO-1 fluorescence of BzATP-treated samples had less variability when collected by the bead-adjusted method and was less influenced by the compensation strategy used. The average day-to-day coefficient of variance for assessments of P2X(7) pore activity by this method was 0.11 +/- 0.04, and the exclusion of nonviable cells was found to accommodate samples aged up to 4 days after phlebotomy. The bead-adjusted set-up method produced measurements differing by only 2.0% +/- 1.5% on two analog cytometers, and within similar decades when comparing analog to digital instruments. CONCLUSIONS These results provide a standardized method for quantitative flow cytometric analysis of P2X(7) receptor phenotypes in blood monocytes with minimal intralaboratory variation and potential for interlaboratory comparisons that can greatly facilitate multicenter functional genomic clinical studies.
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Affiliation(s)
- N L Korpi-Steiner
- Department of Medicine-Allergy, Pulmonary & Critical Care, University of Wisconsin-Madison, Madison, WI 53792, USA
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