1
|
Bourgoin P, Dupont T, Agabriel C, Carsin A, Verles A, Cabanski M, Vitaliti A, Busnel JM. Possible alternative strategies to implement basophil activation testing in multicentric studies. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2024. [PMID: 38572669 DOI: 10.1002/cyto.b.22172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/05/2024]
Abstract
The Basophil Activation Test (BAT) enables flow cytometry characterization of basophil reactivity against specific allergenic molecules. The focus now revolves around democratizing this tool, but, as blood sample stability could be challenging, after having developed a simplified approach, herein, we aimed to characterize two strategies for implementing BAT in multicentric studies: store and ship blood before or after sample processing. Fresh heparin- and EDTA-anticoagulated whole blood samples followed both BAT workflows: "collect, store, process & analyze" or "collect, process, store & analyze". Storage temperatures of 18-25 °C or 2-8 °C and preservation times from 0 to 7 days were considered. Interleukin-3 was also evaluated. With the "collect, store, process & analyze" workflow, heparin-anticoagulated blood and 18-25 °C storage were better than other conditions. While remaining possible, basophil activation exhibited a possible reactivity decay after 24 h. Under the conditions tested, interleukin-3 had no role in enhancing basophil reactivity after storage. Conversely, the "collect, process, store & analyze" workflow demonstrated that either heparin- or EDTA-anticoagulated blood can be processed and kept up to 7 days at 18-25 °C or 2-8 °C before being analyzed. Various strategies can be implemented to integrate BAT in multicentric studies. The "collect, store, process & analyze" workflow remains a simplified logistical approach, but depending on time required to ship from the clinical centers to the reference laboratories, it might not be applicable, or should be used with caution. The "collect, process, store & analyze" workflow may constitute a workflow improvement to provide significant flexibility without impact on basophil reactivity.
Collapse
Affiliation(s)
- Pénélope Bourgoin
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France
| | - Thomas Dupont
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France
| | - Chantal Agabriel
- Department of Pediatric Emergency Medicine, Timone University Hospital, APHM, Marseille, France
| | - Ania Carsin
- Department of Pediatric Emergency Medicine, Saint Joseph Hospital, Marseille, France
| | - Aurélie Verles
- BioMarker Development, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Maciej Cabanski
- BioMarker Development, Novartis Institutes for Biomedical Research, Basel, Switzerland
- Biomarkers and CDx, Monte Rosa Therapeutics, Basel, Switzerland
| | - Alessandra Vitaliti
- BioMarker Development, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Jean-Marc Busnel
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France
| |
Collapse
|
2
|
Glencross DK, Swart L, Pretorius M, Lawrie D. Evaluation of fixed-panel, multicolour ClearLLab 10C at an academic flow cytometry laboratory in Johannesburg, South Africa. Afr J Lab Med 2022; 11:1458. [PMID: 35937760 PMCID: PMC9350555 DOI: 10.4102/ajlm.v11i1.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Flow cytometric immunophenotyping is well established for the diagnosis of haematological neoplasms. New commercially available systems offer fixed, pre-aliquoted multi-parameter analysis to simplify sample preparation and standardise data analysis. Objective The Beckman Coulter (BC) ClearLLab™ 10C (4-tube) system was evaluated against an existing laboratory developed test (LDT). Methods Peripheral blood and bone marrow aspirates (n = 101), tested between August 2019 and November 2019 at an academic pathology laboratory in Johannesburg, South Africa, were analysed. Following daily instrument quality control, samples were prepared for LDT (using > 20 2–4-colour in-house panels and an extensive liquid monoclonal reagent repertoire) or ClearLLab 10C, and respectively analysed using in-house protocols on a Becton Dickinson FACSCalibur, or manufacturer-directed protocols on a BC Navios. Becton Dickinson Paint-a-Gate or BC Kaluza C software facilitated data interpretation. Diagnostic accuracy (concordance) was established by calculating sensitivity and specificity outcomes. Results Excellent agreement (clinical diagnostic concordance) with 100% specificity and sensitivity was established between LDT and ClearLLab 10C in 67 patients with a haematological neoplasm and 34 participants with no haematological disease. Similar acceptable diagnostic concordance (97%) was noted when comparing ClearLLab 10C to clinicopathological outcomes. Additionally, the ClearLLab 10C panels, analysed with Kaluza C software, enabled simultaneous discrimination of disease and concurrent background myeloid and lymphoid haematological populations, including assessing stages of maturation or sub-populations. Conclusion ClearLLab 10C panels provide excellent agreement to existing LDTs and may reliably be used for immunophenotyping of haematological neoplasms, simplifying and standardising sample preparation and data acquisition.
Collapse
Affiliation(s)
- Deborah K Glencross
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Leanne Swart
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Melanie Pretorius
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| |
Collapse
|
3
|
Li JL, Lin YC, Wang YF, Monaghan SA, Ko BS, Lee CC. A Chunking-for-Pooling Strategy for Cytometric Representation Learning for Automatic Hematologic Malignancy Classification. IEEE J Biomed Health Inform 2022; 26:4773-4784. [PMID: 35588419 DOI: 10.1109/jbhi.2022.3175514] [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: 11/07/2022]
Abstract
Differentiating types of hematologic malignancies is vital to determine therapeutic strategies for the newly diagnosed patients. Flow cytometry (FC) can be used as diagnostic indicator by measuring the multi-parameter fluorescent markers on thousands of antibody-bound cells, but the manual interpretation of large scale flow cytometry data has long been a time-consuming and complicated task for hematologists and laboratory professionals. Past studies have led to the development of representation learning algorithms to perform sample-level automatic classification. In this work, we propose a chunking-for-pooling strategy to include large-scale FC data into a supervised deep representation learning procedure for automatic hematologic malignancy classification. The use of discriminatively-trained representation learning strategy and the fixed-size chunking and pooling design are key components of this framework. It improves the discriminative power of the FC sample-level embedding and simultaneously addresses the robustness issue due to an inevitable use of down-sampling in conventional distribution based approaches for deriving FC representation. We evaluated our framework on two datasets. Our framework outperformed other baseline methods and achieved 92.3% unweighted average recall (UAR) for four-class recognition on the UPMC dataset and 85.0% UAR for five-class recognition on the hema.to dataset. We further compared the robustness of our proposed framework with that of the traditional downsampling approach. Analysis of the effects of the chunk size and the error cases revealed further insights about different hematologic malignancy characteristics in the FC data.
Collapse
|
4
|
Olesch C, Brunn D, Aktay-Cetin Ö, Sirait-Fischer E, Pullamsetti SS, Grimminger F, Seeger W, Brüne B, Weigert A, Savai R. Picturing of the Lung Tumor Cellular Composition by Multispectral Flow Cytometry. Front Immunol 2022; 13:827719. [PMID: 35145525 PMCID: PMC8821098 DOI: 10.3389/fimmu.2022.827719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
The lung tumor microenvironment plays a critical role in the tumorigenesis and metastasis of lung cancer, resulting from the crosstalk between cancer cells and microenvironmental cells. Therefore, comprehensive identification and characterization of cell populations in the complex lung structure is crucial for development of novel targeted anti-cancer therapies. Here, a hierarchical clustering approach with multispectral flow cytometry was established to delineate the cellular landscape of murine lungs under steady-state and cancer conditions. Fluorochromes were used multiple times to be able to measure 24 cell surface markers with only 13 detectors, yielding a broad picture for whole-lung phenotyping. Primary and metastatic murine lung tumor models were included to detect major cell populations in the lung, and to identify alterations to the distribution patterns in these models. In the primary tumor models, major altered populations included CD324+ epithelial cells, alveolar macrophages, dendritic cells, and blood and lymph endothelial cells. The number of fibroblasts, vascular smooth muscle cells, monocytes (Ly6C+ and Ly6C–) and neutrophils were elevated in metastatic models of lung cancer. Thus, the proposed clustering approach is a promising method to resolve cell populations from complex organs in detail even with basic flow cytometers.
Collapse
Affiliation(s)
- Catherine Olesch
- Institute of Biochemistry I, Goethe-University Frankfurt, Frankfurt, Germany
| | - David Brunn
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), Bad Nauheim, Germany
| | - Öznur Aktay-Cetin
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), Bad Nauheim, Germany
| | | | - Soni Savai Pullamsetti
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
| | - Friedrich Grimminger
- Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus Liebig University Giessen, Member of the DZL, Member of CPI, Giessen, Germany
| | - Werner Seeger
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus Liebig University Giessen, Member of the DZL, Member of CPI, Giessen, Germany
| | - Bernhard Brüne
- Institute of Biochemistry I, Goethe-University Frankfurt, Frankfurt, Germany
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Frankfurt, Germany
| | - Andreas Weigert
- Institute of Biochemistry I, Goethe-University Frankfurt, Frankfurt, Germany
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Frankfurt, Germany
- *Correspondence: Andreas Weigert, ; Rajkumar Savai, ;
| | - Rajkumar Savai
- Max Planck Institute for Heart and Lung Research, Member of the German Center for Lung Research (DZL), Member of the Cardio-Pulmonary Institute (CPI), Bad Nauheim, Germany
- Institute for Lung Health (ILH), Justus Liebig University, Giessen, Germany
- Department of Internal Medicine, Justus Liebig University Giessen, Member of the DZL, Member of CPI, Giessen, Germany
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
- *Correspondence: Andreas Weigert, ; Rajkumar Savai, ;
| |
Collapse
|
5
|
Wang W, Li Y, Ali H, Zhao L, Mei D, Hu W, Jiang B. Aberrant expression of CD54 detected by flow cytometry is a characteristic of B-lymphoma cells in bone marrow specimens. BMC Cancer 2021; 21:1315. [PMID: 34879826 PMCID: PMC8653582 DOI: 10.1186/s12885-021-09061-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Flow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-NHL). The majority of screen panels of FC still rely on finding monoclonal B-cells, e.g., B-cells with immunoglobin (Ig) light-chain restriction, which has many limitations. Therefore, exploring new markers is warranted. Methods A total of 52 cases of B-NHL with BM involvement were collected. The median age was 60 years. Out of these 52 cases, 34 were male, and 18 were female. A 10-color FC panel was used to detect the expression of CD54 on lymphoma cells. The expression of CD54 was calculated as the mean fluorescence index ratio (MFIR) and was described as the mean ± standard error of the mean (SEM). Results Up to 18/52 (34.62%) of BM specimens abnormally expressed an increased level of CD54, including 1/10 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 9/13 cases of mantle cell lymphoma (MCL), 2/14 cases of follicular lymphoma (FL), 5/9 cases of marginal zone lymphoma (MZL), and 1/3 cases of high-grade B-NHL (HG B-NHL). The expression level of CD54 was significantly increased in MCL cases (53.41 ± 11.04) compared with CLL/SLL cases (11.66 ± 2.79) and FL cases (13.49 ± 2.81). The lowest percentage of CD54-positive B-cells attained 0.13%. In 5/9 cases of MZL and 1/3 cases of HG B-NHL, increased expression of CD54 was the only abnormal immunophenotype detected besides Ig light-chain restriction. No aberrant CD54 expression was identified by FC in lymphoplasmacytic lymphoma (LPL) (0/2) and Burkitt lymphoma (BL) (0/1) cases. Aberrant expression of CD54 was not related to plasma cell differentiation. Conclusion Lymphoma cells, especially in MCL and MZL cases, frequently show increased expression of CD54. Such aberrant expression is not related to plasma cell differentiation. We highly recommend adding CD54 to the FC screening panel to detect BM involvement in patients with B-NHL.
Collapse
Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Yan Li
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Haval Ali
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Linjun Zhao
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Di Mei
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Wenqing Hu
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Bin Jiang
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China.
| |
Collapse
|
6
|
Huys EHLPG, Hobo W, Preijers FWMB. OMIP - 081: A new 21-monoclonal antibody 10-color panel for diagnostic polychromatic immunophenotyping. Cytometry A 2021; 101:117-121. [PMID: 34719867 DOI: 10.1002/cyto.a.24511] [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: 04/15/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 11/06/2022]
Abstract
The 10-color panel consisting of 21 monoclonal antibodies (mAbs) is developed as a one-tube panel to detect leukemia and lymphoma cells in all hematopoietic cell lineages. In particular, this tube is mentioned for a fast screening to identify aberrant cells in samples suspected for malignant cell localization and to enable comprehensive immunophenotyping of samples with low cell counts. The panel contains mAbs for selection of the populations and mAbs against target antigens on the various hematopoietic maturation stages. Due to the limited number of PMTs in most used flow cytometers for clinical purposes, stacking of conjugates in one color is needed to include all relevant markers for simultaneous analysis of the aberrant cells. The 21-mAb panel is tested on peripheral blood (PB), and bone marrow (BM) samples and enables an efficient and correct identification of hematological malignancies. This panel improves the diagnostic potential.
Collapse
Affiliation(s)
- Erik H L P G Huys
- Department of Laboratory Medicine, Laboratory for Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willemijn Hobo
- Department of Laboratory Medicine, Laboratory for Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank W M B Preijers
- Department of Laboratory Medicine, Laboratory for Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
7
|
Lot-to-lot reproducibility, stability and life cycle management of antibody reagents for flow cytometry. Bioanalysis 2021; 13:745-759. [PMID: 34009005 DOI: 10.4155/bio-2020-0320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The increasing number of biopharmaceuticals, gene and cell therapies in development has seen a growing use of flow cytometry to measure biomarkers, generate pharmacokinetic data, assess immunogenicity and investigate target engagement. The importance of these data types and their inclusion in regulatory submissions mean that flow cytometry analyses are now expected to demonstrate robust performance and comply with both regulatory and scientific recommendations during their validation and subsequent use in sample analysis. The control of the 'critical reagents' commonly used in flow cytometry presents some specific challenges, particularly when an assay is required for use over a long period of time across different phases of a drug development program, or where it is deployed in complex, multisite clinical studies. This paper highlights some key challenges in flow cytometry reagent management with some of the strategies employed to control and monitor flow cytometry critical reagents.
Collapse
|
8
|
Hedley BD, Cheng G, Keeney M, Kern W, Padurean A, Luider J, Chin‐Yee I, Lowes LE, Rohrbach J, Ortega R, Smit A, Lo K, Magari R, Tejidor L. A multicenter study evaluation of the ClearLLab 10C panels. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2021; 100:225-234. [PMID: 32667744 PMCID: PMC8048967 DOI: 10.1002/cyto.b.21935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/20/2020] [Accepted: 06/16/2020] [Indexed: 11/26/2022]
Abstract
Multiparameter flow cytometry plays an important role in the diagnosis, staging, and monitoring of patients with a suspected hematological malignancy. The ClearLLab 10C Panels consist of four reagent panels (B-Lineage Tube, T-Lineage Tube, and 2 Myeloid Lineage Tubes), each consisting of 10 color/10 antibody conjugates utilizing Beckman Coulters proprietary dry format optimized for investigating patients with suspected leukemia or lymphoma. A multicenter study was conducted to evaluate the performance of the ClearLLab 10C Panels for qualitative assessment of normal versus abnormal phenotype in peripheral blood, bone marrow, and lymph node samples with suspected hematological malignancies. ClearLLab 10C was compared to laboratory developed tests (LDTs) and final clinical diagnosis. Four clinical sites were used to enroll patient's spent specimens (n = 453); three laboratories in North America and one in Europe. Of the 453 specimens, 198 had no malignancy and 255 contained an abnormal population. The diagnostic accuracy of the ClearLLab 10C Panels was achieved with sensitivity of 96% and specificity of 95% with respect to patient final clinical diagnosis. The agreement of phenotyping between ClearLLab10C Panels and LDTs was 98%. Any differences noted between ClearLLab 10C and LDT were due to either the presence of populations below the level of detection, the lack of clinical information provided to the evaluators, or marker(s) not present in these panels. Overall, the ClearLLab 10C demonstrated excellent agreement to LDTs and diagnosis. These four reagent panels can be adopted by individual laboratories to assess the presence or absence of malignancy.
Collapse
Affiliation(s)
- Benjamin D. Hedley
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Guoyan Cheng
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Michael Keeney
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Wolfgang Kern
- MLL Munich Leukemia LaboratoryDepartment of ImmunophenotypingMunichGermany
| | - Adrian Padurean
- Neogenomics Laboratory, Inc.Department of Flow CytometryFort MyersFloridaUSA
| | - Joanne Luider
- Calgary Laboratory ServicesFlow Cytometry CalgaryAlbertaCanada
| | - Ian Chin‐Yee
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Lori E. Lowes
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Justin Rohrbach
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Robert Ortega
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Astrid Smit
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Ka‐Wai Lo
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Robert Magari
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Liliana Tejidor
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| |
Collapse
|
9
|
Meier L, Carlson R, Neßler J, Tipold A. Stability of canine and feline cerebrospinal fluid samples regarding total cell count and cell populations stored in "TransFix®/EDTA CSF sample storage tubes". BMC Vet Res 2020; 16:487. [PMID: 33334339 PMCID: PMC7745459 DOI: 10.1186/s12917-020-02698-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022] Open
Abstract
Background Because of fast leucocyte degeneration in cerebrospinal fluid (CSF) laboratory examinations of CSF samples should be performed approximately within 30 min after withdrawal. This study examines the storage of canine and feline CSF samples in “TransFix®/EDTA CSF Sample Storage Tubes” (Cytomark, Buckingham, UK) for preventing leucocytes from degeneration, so that routine and flow cytometry examinations are feasible up to 3 days after sampling. Results After storage in TransFix® tubes, leukocytes could not be adequately stained with Türk’s solution and differentiating between erythrocytes and leukocytes was cumbersome. In addition, the cell morphology could not be sufficiently assessed on cytospin preparations because of shrunken leukocytes and indistinct cell nuclei. In contrast, by flow cytometry, a significantly higher cell count was measured over the entire study period in the samples stored in TransFix® tubes compared to the untreated samples. The antibodies (AB) against CD3, CD4 and CD21, against CD11b and against CD45 showed a good binding strength and thus enabled a good differentiation of cell populations. However, after storage in the TransFix® tubes, monocytes were no longer detectable using an AB against CD14. Conclusion Based on these results, “TransFix®/EDTA CSF Sample Storage Tubes” can be used for extended storage prior to flow cytometric analysis of lymphocytes and granulocytes in CSF samples but not for detecting monocytes. However, standard examinations, such as microscopic cell counting and morphological cell assessment should be performed on fresh CSF samples. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-020-02698-5.
Collapse
Affiliation(s)
- Laura Meier
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany.
| | - Regina Carlson
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Jasmin Neßler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| |
Collapse
|
10
|
Multicentre Harmonisation of a Six-Colour Flow Cytometry Panel for Naïve/Memory T Cell Immunomonitoring. J Immunol Res 2020; 2020:1938704. [PMID: 32322591 PMCID: PMC7153001 DOI: 10.1155/2020/1938704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/10/2020] [Accepted: 02/26/2020] [Indexed: 01/17/2023] Open
Abstract
Background Personalised medicine in oncology needs standardised immunological assays. Flow cytometry (FCM) methods represent an essential tool for immunomonitoring, and their harmonisation is crucial to obtain comparable data in multicentre clinical trials. The objective of this study was to design a harmonisation workflow able to address the most effective issues contributing to intra- and interoperator variabilities in a multicentre project. Methods The Italian National Institute of Health (Istituto Superiore di Sanità, ISS) managed a multiparametric flow cytometric panel harmonisation among thirteen operators belonging to five clinical and research centres of Lazio region (Italy). The panel was based on a backbone mixture of dried antibodies (anti-CD3, anti-CD4, anti-CD8, anti-CD45RA, and anti-CCR7) to detect naïve/memory T cells, recognised as potential prognostic/predictive immunological biomarkers in cancer immunotherapies. The coordinating centre distributed frozen peripheral blood mononuclear cells (PBMCs) and fresh whole blood (WB) samples from healthy donors, reagents, and Standard Operating Procedures (SOPs) to participants who performed experiments by their own equipment, in order to mimic a real-life scenario. Operators returned raw and locally analysed data to ISS for central analysis and statistical elaboration. Results Harmonised and reproducible results were obtained by sharing experimental set-up and procedures along with centralising data analysis, leading to a reduction of cross-centre variability for naïve/memory subset frequencies particularly in the whole blood setting. Conclusion Our experimental and analytical working process proved to be suitable for the harmonisation of FCM assays in a multicentre setting, where high-quality data are required to evaluate potential immunological markers, which may contribute to select better therapeutic options.
Collapse
|
11
|
Bento L, Correia R, Sousa F, Vaz A, Pedro E, Schimidell D, Millan N, Passaro M, Barroso R, Bacal N. Performance of eight‐color dry antibody reagent in the detection of minimal residual disease in chronic lymphocytic leukemia samples. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 98:529-535. [DOI: 10.1002/cyto.b.21875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Laiz Bento
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Rodolfo Correia
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Flávia Sousa
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Andressa Vaz
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Eduardo Pedro
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Daniela Schimidell
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Nadila Millan
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Marilia Passaro
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Rodrigo Barroso
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| | - Nydia Bacal
- Flow Cytometry Clinical Laboratory Hospital Isarelita Albert Einstein São Paulo Brazil
| |
Collapse
|
12
|
Bourgoin P, Lediagon G, Arnoux I, Bernot D, Morange PE, Michelet P, Malergue F, Markarian T. Flow cytometry evaluation of infection-related biomarkers in febrile subjects in the emergency department. Future Microbiol 2020; 15:189-201. [PMID: 32065550 DOI: 10.2217/fmb-2019-0256] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: In an Emergency Department (ED), the etiological identification of infected subjects is essential. 13 infection-related biomarkers were assessed using a new flow cytometry procedure. Materials & methods: If subjects presented with febrile symptoms at the ED, 13 biomarkers' levels, including CD64 on neutrophils (nCD64) and CD169 on monocytes (mCD169), were tested and compared with clinical records. Results: Among 50 subjects, 78% had bacterial infections and 8% had viral infections. nCD64 showed 82% sensitivity and 91% specificity for identifying subjects with bacterial infections. mCD169, HLA-ABC ratio and HLA-DR on monocytes had high values in subjects with viral infections. Conclusion: Biomarkers showed promising performances to improve the ED's infectious stratification.
Collapse
Affiliation(s)
- Pénélope Bourgoin
- Department of Research & Development, Beckman Coulter Life Sciences-Immunotech, 130 Avenue de Lattre de Tassigny, 13009 Marseille, France.,C2VN INSERM-INRA, Aix-Marseille University, 27 Boulevard Jean Moulin, 13385 Marseille, France
| | - Guillaume Lediagon
- Adult Emergency Unit, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Isabelle Arnoux
- Hematology Laboratory, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Denis Bernot
- Hematology Laboratory, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Pierre-Emmanuel Morange
- C2VN INSERM-INRA, Aix-Marseille University, 27 Boulevard Jean Moulin, 13385 Marseille, France.,Hematology Laboratory, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Pierre Michelet
- Adult Emergency Unit, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| | - Fabrice Malergue
- Department of Research & Development, Beckman Coulter Life Sciences-Immunotech, 130 Avenue de Lattre de Tassigny, 13009 Marseille, France
| | - Thibaut Markarian
- Adult Emergency Unit, La Timone Hospital, APHM, 264 Rue Saint Pierre, 13385 Marseille, France
| |
Collapse
|
13
|
Cherian S, Hedley BD, Keeney M. Common flow cytometry pitfalls in diagnostic hematopathology. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 96:449-463. [DOI: 10.1002/cyto.b.21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/16/2019] [Accepted: 10/22/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Sindhu Cherian
- Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - Ben D. Hedley
- Department of Pathology and Laboratory Medicine, London Health Sciences Center, London, Ontario Canada
| | - Michael Keeney
- Department of Pathology and Laboratory Medicine, London Health Sciences Center, London, Ontario Canada
| |
Collapse
|
14
|
Heinzelman P, Low A, Simeon R, Wright GA, Chen Z. De Novo Isolation & Affinity Maturation of yeast-displayed Virion-binding human fibronectin domains by flow cytometric screening against Virions. J Biol Eng 2019; 13:76. [PMID: 31636701 PMCID: PMC6796422 DOI: 10.1186/s13036-019-0203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The promise of biopharmaceuticals comprising one or more binding domains motivates the development of novel methods for de novo isolation and affinity maturation of virion-binding domains. Identifying avenues for overcoming the challenges associated with using virions as screening reagents is paramount given the difficulties associated with obtaining high-purity virus-associated proteins that retain the conformation exhibited on the virion surface. RESULTS Fluorescence activated cell sorting (FACS) of 1.5 × 107 clones taken from a naïve yeast surface-displayed human fibronectin domain (Fn3) against whole virions yielded two unique binders to Zika virions. Construction and FACS of site-directed binding loop mutant libraries based on one of these binders yielded multiple progeny clones with enhanced Zika-binding affinities. These affinity-matured clones bound Zika virions with low double- or single-digit nanomolar affinity in ELISA assays, and expressed well as soluble proteins in E. coli shake flask culture, with post-purification yields exceeding 10 mg/L. CONCLUSIONS FACS of a yeast-displayed binding domain library is an efficient method for de novo isolation of virion-binding domains. Affinities of isolated virion-binding clones are readily enhanced via FACS screening of mutant progeny libraries. Given that most binding domains are compatible with yeast display, the approach taken in this work may be broadly utilized for generating virion-binding domains against many different viruses for use in passive immunotherapy and the prevention of viral infection.
Collapse
Affiliation(s)
- Pete Heinzelman
- Department of Microbial Pathogenesis & Immunology, Texas A&M University, College Station, Texas 77843 USA
| | - Alyssa Low
- Department of Microbial Pathogenesis & Immunology, Texas A&M University, College Station, Texas 77843 USA
| | - Rudo Simeon
- Department of Microbial Pathogenesis & Immunology, Texas A&M University, College Station, Texas 77843 USA
| | - Gus A. Wright
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas 77843 USA
| | - Zhilei Chen
- Department of Microbial Pathogenesis & Immunology, Texas A&M University, College Station, Texas 77843 USA
| |
Collapse
|
15
|
Gounari E, Tsavdaridou V, Ioakeimidou A, Haidich AB, Skoura L. Evaluation of a 10color protocol as part of a 2tube screening panel for flow cytometric assessment of peripheral blood leukocytic subsets. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:475-483. [PMID: 31497995 DOI: 10.1080/00365513.2019.1661007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Peripheral blood (PB) immunophenotyping is commonly required for initial evaluation of various suspected disease entities. Several approaches have been proposed. The objective of this work is to explore the value of a 10color protocol developed in our laboratory for flow cytometric assessment of PB leukocytic subsets, as part of a 2tube screening panel. A combination of CD16/CD56/CD34/CD33/CD19/CD4/CD8/CD3/CD20/CD45 antibodies in 1 tube was applied routinely during flow cytometric analysis of PB samples for diagnostic purposes. The protocol was systematically complemented by a 2nd tube with anti-kappa, anti-lambda, CD5, CD19, and CD45 antibodies for adults and selected pediatric patients, and specifically oriented panels when necessary. 25 samples with no detectable neoplastic PB involvement and 31 samples with a hematolymphoid disorder were investigated retrospectively. The contribution of CD33 in the separation of leukocytic populations, as well as the benefits from the simultaneous assessment of CD20/CD19/CD45, CD16/CD56 and the detection of CD34+ cells were examined. The gating strategy with the use of CD33 provided additional information in certain cases. The protocol enabled recognition of differential expression of CD20 and CD45 in CD19+ cells with chronic lymphocytic leukemia phenotype, overall evaluation of NK and NK like T cells, estimation of CD16- granulocytes and CD56/CD16 expression in monocytes, as well as identification of minor cell subsets, such as CD34+ cells. The proposed 10color combination of antibodies analyzed in a standardized manner can offer significant information in the initial evaluation of PB samples, thus, guiding subsequent investigation if needed.
Collapse
Affiliation(s)
- Evdoxia Gounari
- Department of Immunology, Microbiology Laboratory, AHEPA University Hospital , Thessaloniki , Greece
| | - Vasiliki Tsavdaridou
- Department of Immunology, Microbiology Laboratory, AHEPA University Hospital , Thessaloniki , Greece
| | - Aliki Ioakeimidou
- Department of Immunology, Microbiology Laboratory, AHEPA University Hospital , Thessaloniki , Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Faculty of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Lemonia Skoura
- Department of Immunology, Microbiology Laboratory, AHEPA University Hospital , Thessaloniki , Greece
| |
Collapse
|
16
|
Bouriche L, Bernot D, Nivaggioni V, Arnoux I, Loosveld M. Detection of Minimal Residual Disease in B Cell Acute Lymphoblastic Leukemia Using an Eight-Color Tube with Dried Antibody Reagents. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 96:158-163. [PMID: 30698327 DOI: 10.1002/cyto.b.21766] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/13/2018] [Accepted: 01/09/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Flow cytometry is a powerful tool for the detection of minimal residual disease (MRD) of B cell precursor acute lymphoblastic leukemia (BCP-ALL) patients. However, the staining process and the choice of antibodies rely on laboratory expertise and may be source of variability or technical errors. Recently, Beckman Coulter commercialized a ready to use tube with dried format reagents for BCP-ALL MRD detection. The aim of this study is to evaluate the applicability of this tube and to compare it to a conventional (liquid format reagents) method. METHODS Thirty-one samples from B ALL patients were analyzed: 19 bone marrow (BM) aspirations, 10 peripheral blood (PB) samples and 2 cerebrospinal fluids at different stages of the follow-up. In addition, we tested 5 bone marrow samples mixed into non-pathological (control) bone marrow. The dried format tube included seven antibodies: CD45Kro, CD58FITC, CD34ECD, CD10PC5.5, CD19PC7, CD38AA700, CD20AA750, with possibility of additional antibodies for blast markers identified at diagnosis. For comparison, a liquid format tube was prepared, and considered as the reference. RESULTS This tube was validated for daily routine laboratory, with satisfying qualitative (MRD + or MRD-) and quantitative (MRD percentages) correlation with the reference tube. CONCLUSION With this single dried format tube, we showed interesting results for BCP-ALL MRD detection in the aim of standardization and reliable interlaboratory results. It allows accurate MRD detection including low levels (10-4), and offers possibility to increase performance (supplementary antibody) within a preestablished effective antibody panel for BCP-ALL MRD. © 2018 International Clinical Cytometry Society.
Collapse
Affiliation(s)
- Lakhdar Bouriche
- Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, Hôpital de la Timone, Marseille, France
| | - Denis Bernot
- Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, Hôpital de la Timone, Marseille, France
| | - Vanessa Nivaggioni
- Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, Hôpital de la Timone, Marseille, France
| | - Isabelle Arnoux
- Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, Hôpital de la Timone, Marseille, France
| | - Marie Loosveld
- Assistance Publique Hôpitaux de Marseille, Laboratoire d'Hématologie, Hôpital de la Timone, Marseille, France.,CNRS, INSERM, CIML, Aix Marseille University, Marseille, France
| |
Collapse
|
17
|
Immunophenotyping Using Dried and Lyophilized Reagents. Methods Mol Biol 2019; 2032:69-79. [PMID: 31522413 DOI: 10.1007/978-1-4939-9650-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Antibody reagents that are used for flow cytometry immunophenotyping have traditionally been prepared by combining individual liquid antibody conjugates into mixtures. These cocktails have limited shelf-life, and their preparation is time-consuming and prone to laboratory error. Manufacturers of these reagents, in collaboration with several clinical and research centers, have made advances in constructing dried antibody cocktails which have addressed many of the problems inherent in preparing the liquid cocktails on the lab bench. This chapter discusses methods for the use of dried reagents.
Collapse
|
18
|
Pitoiset F, Cassard L, El Soufi K, Boselli L, Grivel J, Roux A, Klatzmann D, Chaput N, Rosenzwajg M. Deep phenotyping of immune cell populations by optimized and standardized flow cytometry analyses. Cytometry A 2018; 93:793-802. [DOI: 10.1002/cyto.a.23570] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Fabien Pitoiset
- Sorbonne Universités; UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3); F-75005 Paris France
- Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Pitié-Salpêtrière, AP-HP; F-75651 Paris France
| | - Lydie Cassard
- Laboratory of Immunomonitoring in Oncology; Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23; Villejuif F-94805 France
| | - Karim El Soufi
- Sorbonne Universités; UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3); F-75005 Paris France
- Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Pitié-Salpêtrière, AP-HP; F-75651 Paris France
| | - Lisa Boselli
- Laboratory of Immunomonitoring in Oncology; Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23; Villejuif F-94805 France
| | - Jonathan Grivel
- Laboratory of Immunomonitoring in Oncology; Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23; Villejuif F-94805 France
| | - Alexandra Roux
- Sorbonne Universités; UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3); F-75005 Paris France
- Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Pitié-Salpêtrière, AP-HP; F-75651 Paris France
| | - David Klatzmann
- Sorbonne Universités; UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3); F-75005 Paris France
- Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Pitié-Salpêtrière, AP-HP; F-75651 Paris France
| | - Nathalie Chaput
- Laboratory of Immunomonitoring in Oncology; Gustave Roussy Cancer Campus, CNRS-UMS 3655 and INSERM-US23; Villejuif F-94805 France
- Faculty of Pharmacy, University Paris-Sud; Chatenay-Malabry F-92296 France
| | - Michelle Rosenzwajg
- Sorbonne Universités; UPMC Univ Paris 06, INSERM, UMR S 959, Immunology-Immunopathology- Immunotherapy (I3); F-75005 Paris France
- Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Pitié-Salpêtrière, AP-HP; F-75651 Paris France
| |
Collapse
|
19
|
Panel proposal for the immunophenotypic diagnosis of hematological malignancies. A collaborative consensus from the groupe d'Etude Immunologique des Leucémies (GEIL). CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:542-547. [DOI: 10.1002/cyto.b.21602] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 11/11/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022]
|
20
|
Hedley B, Cheng G, Luider J, Kern W, Lozanski G, Chin-Yee I, Lowes L, Keeney M, Careaga D, Magari R, Tejidor L. Initial flow cytometric evaluation of the Clearllab lymphoid screen. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:707-713. [DOI: 10.1002/cyto.b.21603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022]
Affiliation(s)
- B.D. Hedley
- Pathology and Laboratory Medicine, London Health Sciences Center; London Ontario, N6A 5W9 Canada
| | - G. Cheng
- Clinical Research, Beckman Coulter, Inc.; Miami 33196 Florida
| | - J. Luider
- Calgary Laboratory Services; Calgary T2N 2T9 Alberta Canada
| | - W. Kern
- MLL Munich Leukemia Laboratory; Munich 81377 Bavaria Germany
| | - G. Lozanski
- The Ohio State University; Columbus 43210 Ohio
| | - I. Chin-Yee
- Department of Medicine; Schulich School of Medicine Western University of Ontario; London N6K 5W9 Ontario Canada
| | - L.E. Lowes
- Pathology and Laboratory Medicine, London Health Sciences Center; London Ontario, N6A 5W9 Canada
| | - M. Keeney
- Pathology and Laboratory Medicine, London Health Sciences Center; London Ontario, N6A 5W9 Canada
| | - D. Careaga
- Clinical Research, Beckman Coulter, Inc.; Miami 33196 Florida
| | - R. Magari
- Clinical Research, Beckman Coulter, Inc.; Miami 33196 Florida
| | - L. Tejidor
- Clinical Research, Beckman Coulter, Inc.; Miami 33196 Florida
| |
Collapse
|