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Bisegna ML, Peragine N, Elia L, Matarazzo M, Milani ML, Intoppa S, Di Trani M, Malfona F, Martelli M, De Propris MS. NG2 Molecule Expression in Acute Lymphoblastic Leukemia B Cells: A Flow-Cytometric Marker for the Rapid Identification of KMT2A Gene Rearrangements. Mediterr J Hematol Infect Dis 2024; 16:e2024018. [PMID: 38468826 PMCID: PMC10927233 DOI: 10.4084/mjhid.2024.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Background B-lineage acute lymphoblastic leukemias (B-ALL) harboring rearrangements of the histone lysine [K]-Methyltransferase 2A (KMT2A) gene on chromosome 11q23 (KMT2A-r) represent a category with dismal prognosis. The prompt identification of these cases represents an urgent clinical need. Considering the correlation between rat neuron glial-antigen 2 (NG2) chondroitin-sulfate-proteoglycan molecule expression and KMT2A-r, we aimed to identify an optimized cytofluorimetric diagnostic panel to predict the presence of KMT2A-r. Materials and Methods We evaluated 88 NG2+ B-ALL cases identified with an NG2 positivity threshold >10% from a cohort of 1382 newly diagnosed B-ALLs referred to the Division of Hematology of 'Sapienza' University of Rome. Results Eighty-five of 88 (96.6%) NG2+ B-ALLs harbored KMT2A-r and were mainly pro-B ALL (77/85; 91%). Only 2 B-ALLs with KMT2A-r showed NG2 expression below 10%, probably due to the steroid therapy administered prior to cytofluorimetric analysis.Compared to KMT2A-r-cases, KMT2A r+ B-ALLs showed a higher blast percentage, significantly higher mean fluorescence intensity (MFI) of CD45, CD38, and CD58, and significantly lower MFI of CD34, CD22, TdT, and CD123.The study confirmed differences in CD45, CD34, CD22, and TdT MFI within the same immunologic EGIL group (European Group for the immunological classification of leukemias), indicating no influence of the B-ALLs EGIL subtype on the KMT2A-r+ B-ALLs immunophenotype. Conclusions Our data demonstrate the association between NG2 and KMT2A-r in B-ALLs identify a distinctive immunophenotypic pattern, useful for rapid identification in diagnostic routines of these subtypes of B-ALLs with a poor prognosis that benefits from a specific therapeutic approach.
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Affiliation(s)
| | | | - Loredana Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Mabel Matarazzo
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maria Laura Milani
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Stefania Intoppa
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Mariangela Di Trani
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Francesco Malfona
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maria Stefania De Propris
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
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Cenariu D, Rus I, Bergthorsson JT, Grewal R, Cenariu M, Greiff V, Tigu AB, Dima D, Selicean C, Petrushev B, Zdrenghea M, Fromm J, Aanei CM, Tomuleasa C. Flow Cytometry of CD5-Positive Hairy Cell Leukemia. Mol Diagn Ther 2023; 27:593-599. [PMID: 37291380 DOI: 10.1007/s40291-023-00658-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Hairy cell leukemia (HCL) is a chronic lymphoproliferative disorder for which diagnosis is typically straightforward, based on bone marrow morphology and flow cytometry (FC) or immunohistochemistry. Nevertheless, variants present atypical expressions of cell surface markers, as is the case of CD5, for which the differential diagnosis can be more difficult. The aim of the current paper was to describe diagnosis of HCL with atypical CD5 expression, with an emphasis on FC. METHODS The detailed diagnostic methodology for HCL with atypical CD5 expression is presented, including differential diagnosis from other lymphoproliferative diseases with similar pathologic features, by FC analysis of the bone marrow aspirate. RESULTS Diagnosis of HCL by means of FC started by gating all events based on side scatter (SSC) versus CD45 and B lymphocytes were selected from the lymphocytes gate as CD45/CD19 positive. The gated cells were positive for CD25, CD11c, CD20, and CD103, while CD10 proved to be dim to negative. Moreover, cells positive for CD3, CD4, and CD8, the three pan-T markers, as well as CD19, showed a bright expression of CD5. The atypical CD5 expression is usually correlated with a negative prognosis and thus chemotherapy with cladribine should be initiated. CONCLUSION HCL is an indolent chronic lymphoproliferative disorder and diagnosis is usually straightforward. However, atypical expression of CD5 renders its differential diagnosis more difficult, but FC is a useful tool that allows an optimal classification of the disease and allows initiation of timely satisfactory therapy.
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Affiliation(s)
- Diana Cenariu
- Medfuture Research Center for Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Louis Pasteur Street, Cluj-Napoca, Romania
| | - Ioana Rus
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Jon Thor Bergthorsson
- Stem Cell Research Unit, Biomedical Center, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Ravnit Grewal
- Department of Pathology, National Health Laboratory Services, Port Elizabeth, South Africa
| | - Mihai Cenariu
- Department of Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Victor Greiff
- Laboratory for Computational and Systems Immunology, University of Oslo, Oslo, Norway
| | - Adrian-Bogdan Tigu
- Medfuture Research Center for Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Louis Pasteur Street, Cluj-Napoca, Romania
| | - Delia Dima
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Cristina Selicean
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Bobe Petrushev
- Medfuture Research Center for Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Louis Pasteur Street, Cluj-Napoca, Romania
| | - Mihnea Zdrenghea
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Jonathan Fromm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Carmen-Mariana Aanei
- Haematology Laboratory, University Hospital of Saint-Etienne, Saint-Etienne, France
- INSERM U1059-SAINBIOSE, Université de Lyon, Saint-Etienne, France
| | - Ciprian Tomuleasa
- Medfuture Research Center for Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Louis Pasteur Street, Cluj-Napoca, Romania.
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Single-cell profiling reveals a memory B cell-like subtype of follicular lymphoma with increased transformation risk. Nat Commun 2022; 13:6772. [PMID: 36351924 PMCID: PMC9646774 DOI: 10.1038/s41467-022-34408-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Follicular lymphoma (FL) is an indolent cancer of mature B-cells but with ongoing risk of transformation to more aggressive histology over time. Recurrent mutations associated with transformation have been identified; however, prognostic features that can be discerned at diagnosis could be clinically useful. We present here comprehensive profiling of both tumor and immune compartments in 155 diagnostic FL biopsies at single-cell resolution by mass cytometry. This revealed a diversity of phenotypes but included two recurrent patterns, one which closely resembles germinal center B-cells (GCB) and another which appears more related to memory B-cells (MB). GCB-type tumors are enriched for EZH2, TNFRSF14, and MEF2B mutations, while MB-type tumors contain increased follicular helper T-cells. MB-type and intratumoral phenotypic diversity are independently associated with increased risk of transformation, supporting biological relevance of these features. Notably, a reduced 26-marker panel retains sufficient information to allow phenotypic profiling of future cohorts by conventional flow cytometry.
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Commonly Assessed Markers in Childhood BCP-ALL Diagnostic Panels and Their Association with Genetic Aberrations and Outcome Prediction. Genes (Basel) 2022; 13:genes13081374. [PMID: 36011285 PMCID: PMC9407579 DOI: 10.3390/genes13081374] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/05/2022] Open
Abstract
Immunophenotypic characterization of leukemic cells with the use of flow cytometry (FC) is a fundamental tool in acute lymphoblastic leukemia (ALL) diagnostics. A variety of genetic aberrations underlie specific B-cell precursor ALL (BCP-ALL) subtypes and their identification is of great importance for risk group stratification. These aberrations include: ETV6::RUNX1 fusion gene, Philadelphia chromosome (BCR::ABL1 fusion gene), rearrangements of the KMT2A, TCF3::PBX1 fusion gene and changes in chromosome number (hyperdiploidy and hypodiploidy). Diagnostic panels for BCP-ALL usually include B-cell lineage specific antigens: CD19, CD10, CD20, maturation stage markers: CD34, CD10, CD38, TdT, IgM and other markers useful for possible genetic subtype indication. Some genetic features of leukemic cells (blasts) are associated with expression of certain antigens. This review comprehensively summarizes all known research data on genotype-immunophenotype correlations in BCP-ALL. In some cases, single molecules are predictive of particular genetic subtypes, i.e., NG2 with KMT2A gene rearrangements or CD123 with hyperdiploidy. However, much more information on possible genotype or prognosis can be obtained with wider (≥8-color) panels. In several studies, a quantitative antigen expression scale and advanced statistical analyses were used to further increase the specificity and sensitivity of genotype/immunophenotype correlation detection. Fast detection of possible genotype/immunophenotype correlations makes multicolor flow cytometry an essential tool for initial leukemia diagnostics and stratification.
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Alnuqaydan AM, Almutary A, Bhat GR, Mir TA, Wani SI, Rather MY, Mir SA, Alshehri B, Alnasser S, Ali Zainy FM, Rah B. Evaluation of the Cytotoxic, Anti-Inflammatory, and Immunomodulatory Effects of Withaferin A (WA) against Lipopolysaccharide (LPS)-Induced Inflammation in Immune Cells Derived from BALB/c Mice. Pharmaceutics 2022; 14:pharmaceutics14061256. [PMID: 35745829 PMCID: PMC9229769 DOI: 10.3390/pharmaceutics14061256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Inflammation is one of the primary responses of the immune system and plays a key role in the pathophysiology of various diseases. Recent reports suggest that various phytochemicals exhibit promising anti-inflammatory and immunomodulation activities with relatively few undesirable effects, thus offering a viable option to deal with inflammation and associated diseases. The current study evaluates the anti-inflammatory and immunomodulatory effects of withaferin A (WA) in immune cells extracted from BALB/c mice. (2) Methods: MTT assays were performed to assess the cell viability of splenocytes and anti-inflammatory doses of WA. Under aseptic conditions, the isolation of macrophages and splenocytes from BALB/c mice was performed to investigate the anti-inflammatory effects of WA. Analysis of the expression of proinflammatory cytokines and associated signaling mediators was performed using proinflammatory assay kits, real-time polymerase chain reaction (RT-PCR), and immunoblotting, while the quantification of B and T cells was performed by flow cytometry. (3) Results: Our results demonstrated that WA exhibits anti-inflammatory and immunomodulatory effects in LPS-stimulated macrophages and splenocytes derived from BALB/c mice, respectively. Mechanistically, we found that WA promotes an anti-inflammatory effect on LPS-stimulated macrophages by attenuating the secretion and expression of proinflammatory cytokines TNF-α, IL-1β, IL-6, and the inflammation modulator NO, both at the transcriptional and translational level, respectively. Further, WA inhibits LPS-stimulated inflammatory signaling by dephosphorylation of p-Akt-Ser473 and p-ERK1/2. This dephosphorylation does not allow IĸB-kinase activation to disrupt IĸB–NF-ĸB interaction. The consistent interaction of IĸB with NF-ĸB in WA-treated cells attenuates the activation of downstream inflammatory signaling mediators Cox-2 and iNOS expression, which play crucial roles in inflammatory signaling. Additionally, we observed significant immunomodulation of LPS-stimulated spleen-derived lymphocytes by suppression of B (CD19) and T (CD4+/CD8+) cell populations after treatment with WA. (4) Conclusion: WA exhibits anti-inflammatory and immunomodulatory activity by modulating Akt/ERK/NF-kB-mediated inflammatory signaling in macrophages and immunosuppression of B (CD19) and T cell (CD4+/CD8+) populations in splenocytes after LPS stimulation. These results suggest that WA could act as a potential anti-inflammatory/immunomodulatory molecule and support its use in the field of immunopharmacology to modulate immune system cells.
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Affiliation(s)
- Abdullah M. Alnuqaydan
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia; (A.M.A.); (A.A.)
| | - Abdulmajeed Almutary
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia; (A.M.A.); (A.A.)
| | - Gh Rasool Bhat
- Advanced Centre for Human Genetics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, Jammu and Kashmir, India; (G.R.B.); (S.I.W.)
| | - Tanveer Ahmad Mir
- Laboratory of Tissue/Organ Bioengineering & BioMEMS, Organ Transplant Centre of Excellence, Transplantation Research & Innovation (Dpt)-R, King Faisal Specialist Hospital and Research Centre, MBC 03, Riyadh 11211, Saudi Arabia;
| | - Shadil Ibrahim Wani
- Advanced Centre for Human Genetics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, Jammu and Kashmir, India; (G.R.B.); (S.I.W.)
| | - Mohd Younis Rather
- Multidisplinary Research Unit, Government Medical College, Srinagar 190010, Jammu and Kashmir, India;
| | - Shabir Ahmad Mir
- Department of Medical Laboratory Sciences, College of Applied Medical Science, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.M.); (B.A.)
| | - Bader Alshehri
- Department of Medical Laboratory Sciences, College of Applied Medical Science, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.M.); (B.A.)
| | - Sulaiman Alnasser
- Department of Pharmacology and Toxicology, Unaizah College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia;
| | - Faten M. Ali Zainy
- Chemistry Department, Faculty of Science, University of Jeddah, Jeddah 21589, Saudi Arabia;
| | - Bilal Rah
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraidah 51452, Saudi Arabia; (A.M.A.); (A.A.)
- Advanced Centre for Human Genetics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar 190011, Jammu and Kashmir, India; (G.R.B.); (S.I.W.)
- Correspondence: or or
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Mihályová J, Hradská K, Jelínek T, Motais B, Celichowski P, Hájek R. Promising Immunotherapeutic Modalities for B-Cell Lymphoproliferative Disorders. Int J Mol Sci 2021; 22:ijms222111470. [PMID: 34768899 PMCID: PMC8584080 DOI: 10.3390/ijms222111470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 12/13/2022] Open
Abstract
Over the last few years, treatment principles have been changed towards more targeted therapy for many B-cell lymphoma subtypes and in chronic lymphocytic leukemia (CLL). Immunotherapeutic modalities, namely monoclonal antibodies (mAbs), bispecific antibodies (bsAbs), antibody-drug conjugates (ADCs), and chimeric antigen receptor T (CAR-T) cell therapy, commonly use B-cell-associated antigens (CD19, CD20, CD22, and CD79b) as one of their targets. T-cell engagers (TCEs), a subclass of bsAbs, work on a similar mechanism as CAR-T cell therapy without the need of previous T-cell manipulation. Currently, several anti-CD20xCD3 TCEs have demonstrated promising efficacy across different lymphoma subtypes with slightly better outcomes in the indolent subset. Anti-CD19xCD3 TCEs are being developed as well but only blinatumomab has been evaluated in clinical trials yet. The results are not so impressive as those with anti-CD19 CAR-T cell therapy. Antibody-drug conjugates targeting different B-cell antigens (CD30, CD79b, CD19) seem to be effective in combination with mAbs, standard chemoimmunotherapy, or immune checkpoint inhibitors. Further investigation will show whether immunotherapy alone or in combinatory regimens has potential to replace chemotherapeutic agents from the first line treatment.
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Affiliation(s)
- Jana Mihályová
- Department of Haematooncology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic; (K.H.); (T.J.); (R.H.)
- Faculty of Medicine, University of Ostrava, 708 52 Ostrava, Czech Republic; (B.M.); (P.C.)
- Correspondence:
| | - Katarína Hradská
- Department of Haematooncology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic; (K.H.); (T.J.); (R.H.)
| | - Tomáš Jelínek
- Department of Haematooncology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic; (K.H.); (T.J.); (R.H.)
- Faculty of Medicine, University of Ostrava, 708 52 Ostrava, Czech Republic; (B.M.); (P.C.)
| | - Benjamin Motais
- Faculty of Medicine, University of Ostrava, 708 52 Ostrava, Czech Republic; (B.M.); (P.C.)
| | - Piotr Celichowski
- Faculty of Medicine, University of Ostrava, 708 52 Ostrava, Czech Republic; (B.M.); (P.C.)
| | - Roman Hájek
- Department of Haematooncology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic; (K.H.); (T.J.); (R.H.)
- Faculty of Medicine, University of Ostrava, 708 52 Ostrava, Czech Republic; (B.M.); (P.C.)
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Chatterjee G, Sriram H, Ghogale S, Deshpande N, Khanka T, Panda D, Pradhan SN, Girase K, Narula G, Dhamane C, Malik NR, Banavali S, Patkar NV, Gujral S, Subramanian PG, Tembhare PR. Immunophenotypic shift in the B-cell precursors from regenerating bone marrow samples: A critical consideration for measurable residual disease assessment in B-lymphoblastic leukemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:434-445. [PMID: 32896101 DOI: 10.1002/cyto.b.21951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/18/2020] [Accepted: 08/19/2020] [Indexed: 01/04/2023]
Abstract
Accurate knowledge of expression patterns/levels of commonly used MRD markers in regenerative normal-B-cell-precursors (BCP) is highly desirable to distinguish leukemic-blasts from regenerative-BCP for multicolor flow cytometry (MFC)-based measurable residual disease (MRD) assessment in B-lymphoblastic leukemia (B-ALL). However, the data highlighting therapy-related immunophenotypic-shift in regenerative-BCPs is scarce and limited to small cohort. Herein, we report the in-depth evaluation of immunophenotypic shift in regenerative-BCPs from a large cohort of BALL-MRD samples. Ten-color MFC-MRD analysis was performed in pediatric-BALL at the end-of-induction (EOI), end-of-consolidation (EOC), and subsequent-follow-up (SFU) time-points. We studied normalized-mean fluorescent intensity (nMFI) and coefficient-of-variation of immunofluorescence (CVIF) of CD10, CD19, CD20, CD34, CD38, and CD45 expression in regenerative-BCP (early, BCP1 and late, BCP2) from 200 BALL-MRD samples, and compared them with BCP from 15 regenerating control (RC) TALL-MRD samples and 20 treatment-naïve bone-marrow control (TNSC) samples. Regenerative-BCP1 showed downregulation in CD10 and CD34 expression with increased CVIF and reduced nMFI (p < 0.001), upregulation of CD20 with increased nMFI (p = 0.014) and heterogeneous CD45 expression with increased CVIF (p < 0.001). Immunophenotypic shift was less pronounced in the BCP2 compared to BCP1 compartment with increased CVIF in all but CD45 (p < 0.05) and reduced nMFI only in CD45 expression (p = 0.005). Downregulation of CD10/CD34 and upregulation of CD20 was higher at EOI than EOC and SFU time-points (p < 0.001). Regenerative-BCPs are characterized by the significant immunophenotypic shift in commonly used B-ALL-MRD markers, especially CD10 and CD34 expression, as compared to treatment-naïve BCPs. Therefore, the templates/database for BMRD analysis must be developed using regenerative-BCP.
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Affiliation(s)
- Gaurav Chatterjee
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Harshini Sriram
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Sitaram Ghogale
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Nilesh Deshpande
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Twinkle Khanka
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Devasis Panda
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Shiv Narayan Pradhan
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Karishma Girase
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Gaurav Narula
- Department of Pediatric Oncology, Tata Memorial Center, HBNI University, Mumbai, India
| | - Chetan Dhamane
- Department of Pediatric Oncology, Tata Memorial Center, HBNI University, Mumbai, India
| | - Nirmlya Roy Malik
- Department of Pediatric Oncology, Tata Memorial Center, HBNI University, Mumbai, India
| | - Shripad Banavali
- Department of Pediatric Oncology, Tata Memorial Center, HBNI University, Mumbai, India
| | - Nikhil V Patkar
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Sumeet Gujral
- Hematopathology Laboratory, Tata Memorial Center, HBNI University, Mumbai, India
| | - Papagudi G Subramanian
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
| | - Prashant R Tembhare
- Hematopathology Laboratory, ACTREC, Tata Memorial Center, HBNI University, Navi Mumbai, India
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EuroFlow Lymphoid Screening Tube (LST) data base for automated identification of blood lymphocyte subsets. J Immunol Methods 2019; 475:112662. [PMID: 31454495 DOI: 10.1016/j.jim.2019.112662] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 02/06/2023]
Abstract
In recent years the volume and complexity of flow cytometry data has increased substantially. This has led to a greater number of identifiable cell populations in a single measurement. Consequently, new gating strategies and new approaches for cell population definition are required. Here we describe how the EuroFlow Lymphoid Screening Tube (LST) reference data base for peripheral blood (PB) samples was designed, constructed and validated for automated gating of the distinct lymphoid (and myeloid) subsets in PB of patients with chronic lymphoproliferative disorders (CLPD). A total of 46 healthy/reactive PB samples which fulfilled pre-defined technical requirements, were used to construct the LST-PB reference data base. In addition, another set of 92 PB samples (corresponding to 10 healthy subjects, 51 B-cell CLPD and 31 T/NK-cell CLPD patients), were used to validate the automated gating and cell-population labeling tools with the Infinicyt software. An overall high performance of the LST-PB data base was observed with a median percentage of alarmed cellular events of 0.8% in 10 healthy donor samples and of 44.4% in CLPD data files containing 49.8% (range: 1.3-96%) tumor cells. The higher percent of alarmed cellular events in every CLPD sample was due to aberrant phenotypes (75.6% cases) and/or to abnormally increased cell counts (86.6% samples). All 18 (22%) data files that only displayed numerical alterations, corresponded to T/NK-cell CLPD cases which showed a lower incidence of aberrant phenotypes (41%) vs B-cell CLPD cases (100%). Comparison between automated vs expert-bases manual classification of normal (r2 = 0.96) and tumor cell populations (rho = 0.99) showed a high degree of correlation. In summary, our results show that automated gating of cell populations based on the EuroFlow LST-PB data base provides an innovative, reliable and reproducible tool for fast and simplified identification of normal vs pathological B and T/NK lymphocytes in PB of CLPD patients.
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Flores-Montero J, Kalina T, Corral-Mateos A, Sanoja-Flores L, Pérez-Andrés M, Martin-Ayuso M, Sedek L, Rejlova K, Mayado A, Fernández P, van der Velden V, Bottcher S, van Dongen JJM, Orfao A. Fluorochrome choices for multi-color flow cytometry. J Immunol Methods 2019; 475:112618. [PMID: 31181212 DOI: 10.1016/j.jim.2019.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
Fluorochrome selection is a key step in designing multi-color antibody panels. The list of available fluorochromes is continuously growing, fitting current needs in clinical flow cytometry to simultaneously use more markers to better define multiple leukocyte subpopulations in a single tube. Several criteria guide fluorochrome selection: i) the fluorescence profiles (excitation and emission), ii) relative brightness, iii) fluorescence overlap, iv) fluorochrome stability, and v) reproducible conjugation to antibodies. Here we used 75 samples (45 bone marrow and 30 blood) to illustrate EuroFlow strategies for evaluation of compatible fluorochromes, and how the results obtained guide fluorochrome selection as a critical step in the antibody-panel building process. Our results allowed identification of optimal fluorescence profiles (e.g. higher fluorescence intensity and/or resolution with limited fluorescence overlap into neighbor channels) for brilliant violet (BV)421 and BV510 in the violet laser and allophycocyanin (APC) hilite 7 (H7) or APC C750 in the red laser vs. other candidate fluorochromes generally applied for the same detectors and here evaluated. Moreover, evaluation of the same characteristics for another group of fluorochromes (e.g. BV605, BV650, PE CF594, AF700 or APC AF700) guided selection of the most appropriate fluorochrome conjugates to be combined in a multi-color antibody panel. Albeit this is a demanding approach, it could be successfully applied for selection of fluorochrome combinations for the EuroFlow antibody panels for diagnosis, classification and monitoring of hematological malignancies and primary immunodeficiencies. Consequently, sets of 8-, 10- and 12-color fluorochrome combinations are proposed as frame of reference for initial antibody panel design.
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Affiliation(s)
- Juan Flores-Montero
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Tomas Kalina
- CLIP Cytometry, Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alba Corral-Mateos
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Luzalba Sanoja-Flores
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Martin Pérez-Andrés
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Lukasz Sedek
- Department of Pediatric Hematology and Oncology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Katerina Rejlova
- CLIP Cytometry, Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andrea Mayado
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Fernández
- FACS/Stem cell Laboratory, Institute of Laboratory Medicine, Kantonsspital Aarau AG, Aarau, Switzerland
| | - Vincent van der Velden
- Department of Immunology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sebastian Bottcher
- Rostock University Medical Center, Division of Internal Medicine, Medical Clinic III, Hematology, Oncology and Palliative Medicine, Special Hematology Laboratory, Rostock, Germany
| | - Jaques J M van Dongen
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.
| | - Alberto Orfao
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain..
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Scott GD, Atwater SK, Gratzinger DA. Normative data for flow cytometry immunophenotyping of benign lymph nodes sampled by surgical biopsy. J Clin Pathol 2017; 71:174-179. [PMID: 28916595 PMCID: PMC5800326 DOI: 10.1136/jclinpath-2017-204687] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/07/2017] [Accepted: 08/13/2017] [Indexed: 11/30/2022]
Abstract
Aims To create clinically relevant normative flow cytometry data for understudied benign lymph nodes and characterise outliers. Methods Clinical, histological and flow cytometry data were collected and distributions summarised for 380 benign lymph node excisional biopsies. Outliers for kappa:lambda light chain ratio, CD10:CD19 coexpression, CD5:CD19 coexpression, CD4:CD8 ratios and CD7 loss were summarised for histological pattern, concomitant diseases and follow-up course. Results We generated the largest data set of benign lymph node immunophenotypes by an order of magnitude. B and T cell antigen outliers often had background immunosuppression or inflammatory disease but did not subsequently develop lymphoma. Conclusions Diagnostic immunophenotyping data from benign lymph nodes provide normative ranges for clinical use. Outliers raising suspicion for B or T cell lymphoma are not infrequent (26% of benign lymph nodes). Caution is indicated when interpreting outliers in the absence of excisional biopsy or clinical history, particularly in patients with concomitant immunosuppression or inflammatory disease.
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Affiliation(s)
- Gregory David Scott
- Department of Pathology, Stanford Hospital and Clinics, Stanford, California, USA
| | - Susan K Atwater
- Department of Pathology, Stanford Hospital and Clinics, Stanford, California, USA
| | - Dita A Gratzinger
- Department of Pathology, Stanford Hospital and Clinics, Stanford, California, USA
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Theunissen PMJ, Sedek L, De Haas V, Szczepanski T, Van Der Sluijs A, Mejstrikova E, Nováková M, Kalina T, Lecrevisse Q, Orfao A, Lankester AC, van Dongen JJM, Van Der Velden VHJ. Detailed immunophenotyping of B-cell precursors in regenerating bone marrow of acute lymphoblastic leukaemia patients: implications for minimal residual disease detection. Br J Haematol 2017; 178:257-266. [DOI: 10.1111/bjh.14682] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/18/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Prisca M. J. Theunissen
- Department of Immunology; Erasmus MC, University Medical Centre Rotterdam; Rotterdam the Netherlands
| | - Lukasz Sedek
- Department of Paediatric Haematology and Oncology; Zabrze Poland
- Medical University of Silesia (SUM); Katowice Poland
| | | | - Tomasz Szczepanski
- Department of Paediatric Haematology and Oncology; Zabrze Poland
- Medical University of Silesia (SUM); Katowice Poland
| | | | - Ester Mejstrikova
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Michaela Nováková
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Tomas Kalina
- Department of Paediatric Haematology and Oncology; 2nd Faculty of Medicine; Charles University (DPH/O) and University Hospital Motol; Prague Czech Republic
| | - Quentin Lecrevisse
- Cancer Research Centre (IBMCC-CSIC); Department of Medicine and Cytometry Service; University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Alberto Orfao
- Cancer Research Centre (IBMCC-CSIC); Department of Medicine and Cytometry Service; University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL); Salamanca Spain
| | - Arjan C. Lankester
- Department of Paediatrics; Leiden University Medical Centre; Leiden the Netherlands
| | - Jacques J. M. van Dongen
- Department of Immunology; Erasmus MC, University Medical Centre Rotterdam; Rotterdam the Netherlands
- Department of Immunohaematology and Blood Transfusion; Leiden University Medical Centre; Leiden the Netherlands
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12
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Li HF, Meng WT, Jia YQ, Jiang NG, Zeng TT, Jin YM, Huang QR, Li X, Xu H, Mo XM. Development-associated immunophenotypes reveal the heterogeneous and individualized early responses of adult B-acute lymphoblastic leukemia. Medicine (Baltimore) 2016; 95:e4128. [PMID: 27559941 PMCID: PMC5400307 DOI: 10.1097/md.0000000000004128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
B cell acute lymphoblastic leukemia (B-ALL) exhibits phenotypes reminiscent of normal stages of B-cell development. As demonstrated by flow cytometry, the immunophenotypes are able to determine the stages of B cell development. Multicolor flow cytometry (MFC) is more accurate at identifying cell populations. In this study, 9-color panels, including CD10, CD19, CD20, CD22, CD34, CD79a, CD179a, and IgM, which are sequentially expressed during B cell development, were designed to detect the leukemia cell subpopulations in adult B-ALL patients. In 23 patients at diagnosis, 192 heterogeneous subpopulations of leukemia cells were detected. Compared with their counterparts at diagnosis and after the 1st course of induction therapy, the responses of the subpopulations were also heterogeneous. In the CD10 population, the residual B cell subpopulations in the BCR/ABL patients were obviously reduced compared to those in the BCR/ABL patients. New subpopulations were detected in 22 of 23 patients and were primarily located in the CD34CD10 populations. Subpopulations of clonal evolution were heterogeneous after induction therapy. Our results suggest that the subpopulations in B-ALL patients should be dynamically monitored by development-associated immunophenotyping before, during, and after induction therapy and to predict the prognosis of the disease.
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Affiliation(s)
- Hui-Fang Li
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Wen-Tong Meng
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
- Correspondence: Wen-Tong Meng, Xian-Ming Mo, Collaborative Innovation Center for Biotherapy, Sichuan University, Building B2, No. 88, Keyuan Nanlu, High-Tech District, Chengdu 610041, China (e-mail: , )
| | | | | | | | - Yong-Mei Jin
- Department of Laboratory Medicine, West China Hospital
| | - Qiao-Rong Huang
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Xue Li
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Hong Xu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Xian-Ming Mo
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy
- Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
- Correspondence: Wen-Tong Meng, Xian-Ming Mo, Collaborative Innovation Center for Biotherapy, Sichuan University, Building B2, No. 88, Keyuan Nanlu, High-Tech District, Chengdu 610041, China (e-mail: , )
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Advanced Diagnostic Techniques. CANINE AND FELINE CYTOLOGY 2016. [PMCID: PMC7158337 DOI: 10.1016/b978-1-4557-4083-3.00017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
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Salari F, Shahjahani M, Shahrabi S, Saki N. Minimal residual disease in acute lymphoblastic leukemia: optimal methods and clinical relevance, pitfalls and recent approaches. Med Oncol 2014; 31:266. [PMID: 25287907 DOI: 10.1007/s12032-014-0266-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/20/2014] [Indexed: 11/29/2022]
Abstract
After advances in experimental and clinical testing, minimal residual disease (MRD) assay results are considered a determining factor in treatment of acute lymphoblastic leukemia patients. According to MRD assay results, bone marrow (BM) leukemic burden and the rate of its decline after treatment can be directly evaluated. Detailed knowledge of the leukemic burden in BM can minimize toxicity and treatment complications in patients by tailoring the therapeutic dose based on patients' conditions. In addition, reduction of MRD before allo-HSCT is an important prerequisite for reception of transplant by the patient. In direct examination of MRD by morphological methods (even by a professional hematologist), leukemic cells can be under- or over-estimated due to similarity with hematopoietic precursor cells. As a result, considering the importance of MRD, it is necessary to use other methods including flow cytometry, polymerase chain reaction (PCR) amplification and RQ-PCR to detect MRD. Each of these methods has its own advantages and disadvantages in terms of accuracy and sensitivity. In this review article, different MRD assay methods and their sensitivity, correlation of MRD assay results with clinical symptoms of the patient as well as pitfalls in results of these methods are evaluated. In the final section, recent advances in MRD have been addressed.
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Affiliation(s)
- Fatemeh Salari
- Health Research Institute, Research Center of Thalassemia and Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Sędek Ł, Bulsa J, Sonsala A, Twardoch M, Wieczorek M, Malinowska I, Derwich K, Niedźwiecki M, Sobol-Milejska G, Kowalczyk JR, Mazur B, Szczepański T. The immunophenotypes of blast cells in B-cell precursor acute lymphoblastic leukemia: How different are they from their normal counterparts? CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 86:329-39. [DOI: 10.1002/cyto.b.21176] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 04/24/2014] [Accepted: 04/24/2014] [Indexed: 01/14/2023]
Affiliation(s)
- Ł. Sędek
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - J. Bulsa
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - A. Sonsala
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - M. Twardoch
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
| | - M. Wieczorek
- Division of Hematology; Chorzów Center of Pediatrics and Oncology; Chorzów Poland
| | - I. Malinowska
- Department of Pediatric Hematology and Oncology; Medical University of Warsaw; Poland
| | - K. Derwich
- Department of Pediatric Hematology; Oncology and Transplantology, University of Medical Sciences; Poznań Poland
| | - M. Niedźwiecki
- Department of Pediatric Hematology; Oncology and Endocrinology, Medical University; Gdansk Poland
| | - G. Sobol-Milejska
- Department of Pediatrics; Medical University of Silesia; Katowice Poland
| | - J. R. Kowalczyk
- Department of Pediatric Hematology and Oncology; Medical University; Lublin Poland
| | - B. Mazur
- Department of Microbiology and Immunology; Medical University of Silesia; Zabrze Poland
| | - T. Szczepański
- Department of Pediatric Hematology and Oncology; Medical University of Silesia; Zabrze Poland
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Aggarwal N, Fischer J, Swerdlow SH, Craig FE. Splenic lymphoid subsets with less well-recognized phenotypes mimic aberrant antigen expression. Am J Clin Pathol 2013; 140:787-94. [PMID: 24225744 DOI: 10.1309/ajcppibh3i1vrwxq] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Flow cytometry can assist in the diagnosis of lymphoma by identifying aberrant antigen expression. Recognition of aberrancy requires knowledge of the phenotype of normal lymphoid cells. METHODS Lymphoid subsets were characterized in 20 spleens removed for traumatic rupture, using 8-color flow cytometry. RESULTS Normal variation in splenic lymphoid subsets was highlighted and several well-recognized subsets were identified: CD5+ B cells (20/20 specimens), CD7- T cells (20/20), and CD3 brightγδT cells (16/20). In addition, less well-recognized lymphoid subsets that resemble those described in lymphoma were identified in all specimens: CD5- T cells (4.5 ± 5.1% of T cells), CD2- natural killer (NK) cells (38 ± 7% of NK cells), and CD7dim+ NK cells. Similar populations were identified in 20 control peripheral blood specimens, where they represented a smaller proportion of total lymphoid cells. CONCLUSIONS Familiarity with the phenotype of normal lymphoid subsets can help prevent misinterpreting flow cytometric data. Furthermore, in the context of neoplastic cells, the phenotype may suggest expanded normal subsets rather than aberrant antigen expression.
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Affiliation(s)
- Nidhi Aggarwal
- Department of Pathology, Division of Hematopathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jason Fischer
- Department of Pathology, Division of Hematopathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Steven H. Swerdlow
- Department of Pathology, Division of Hematopathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Fiona E. Craig
- Department of Pathology, Division of Hematopathology, University of Pittsburgh Medical Center, Pittsburgh, PA
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Pedreira CE, Costa ES, Lecrevisse Q, van Dongen JJ, Orfao A. Overview of clinical flow cytometry data analysis: recent advances and future challenges. Trends Biotechnol 2013; 31:415-25. [DOI: 10.1016/j.tibtech.2013.04.008] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/26/2013] [Accepted: 04/28/2013] [Indexed: 12/15/2022]
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Piątosa B, Birbach M, Siewiera K, Ussowicz M, Kałwak K, Drabko K, Rękawek A, Tkaczyk K, Kurowski PN. Significant changes in the composition of the precursor B-cell compartment in children less than 2 years old. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:179-86. [DOI: 10.1002/cyto.b.21085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/20/2013] [Accepted: 02/04/2013] [Indexed: 11/11/2022]
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Hoffmann JJ. Laboratory hematology in the history of Clinical Chemistry and Laboratory Medicine. Clin Chem Lab Med 2013; 51:119-27. [DOI: 10.1515/cclm-2012-0464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 07/26/2012] [Indexed: 11/15/2022]
Abstract
Abstract
Background: For the occasion of the 50th anniversary of the journal Clinical Chemistry and Laboratory Medicine (CCLM), an historic overview of papers that the journal has published in the field of laboratory hematology (LH) is presented.
Methods: All past volumes of CCLM were screened for papers on LH and these were categorized. Bibliographic data of these papers were also analyzed.
Results:
CCLM published in total 387 LH papers. The absolute number of LH papers published annually showed a significant increase over the years since 1985. Also the share of LH papers demonstrated a steady increase (overall mean 5%, but mean 8% over the past 4 years). The most frequent category was coagulation and fibrinolysis (23.5%). Authors from Germany contributed the most LH papers to the journal (22.7%), followed by the Netherlands and Italy (16.3 and 13.2%, respectively). Recent citation data indicated that other publications cited LH review papers much more frequently than other types of papers.
Conclusions: The history of the journal reflects the emergence and development of laboratory hematology as a separate discipline of laboratory medicine.
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Affiliation(s)
- Johannes J.M.L. Hoffmann
- Abbott Diagnostics Division, Abbott GmbH & Co. KG , Max-Planck-Ring 2, 65205 Wiesbaden-Delkenheim , Germany
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20
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van Dongen JJM, Orfao A. EuroFlow: Resetting leukemia and lymphoma immunophenotyping. Basis for companion diagnostics and personalized medicine. Leukemia 2012; 26:1899-907. [PMID: 22948488 PMCID: PMC3437406 DOI: 10.1038/leu.2012.121] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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21
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van Dongen JJM, Lhermitte L, Böttcher S, Almeida J, van der Velden VHJ, Flores-Montero J, Rawstron A, Asnafi V, Lécrevisse Q, Lucio P, Mejstrikova E, Szczepański T, Kalina T, de Tute R, Brüggemann M, Sedek L, Cullen M, Langerak AW, Mendonça A, Macintyre E, Martin-Ayuso M, Hrusak O, Vidriales MB, Orfao A. EuroFlow antibody panels for standardized n-dimensional flow cytometric immunophenotyping of normal, reactive and malignant leukocytes. Leukemia 2012; 26:1908-75. [PMID: 22552007 PMCID: PMC3437410 DOI: 10.1038/leu.2012.120] [Citation(s) in RCA: 656] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 02/14/2012] [Accepted: 04/19/2012] [Indexed: 12/21/2022]
Abstract
Most consensus leukemia & lymphoma antibody panels consist of lists of markers based on expert opinions, but they have not been validated. Here we present the validated EuroFlow 8-color antibody panels for immunophenotyping of hematological malignancies. The single-tube screening panels and multi-tube classification panels fit into the EuroFlow diagnostic algorithm with entries defined by clinical and laboratory parameters. The panels were constructed in 2-7 sequential design-evaluation-redesign rounds, using novel Infinicyt software tools for multivariate data analysis. Two groups of markers are combined in each 8-color tube: (i) backbone markers to identify distinct cell populations in a sample, and (ii) markers for characterization of specific cell populations. In multi-tube panels, the backbone markers were optimally placed at the same fluorochrome position in every tube, to provide identical multidimensional localization of the target cell population(s). The characterization markers were positioned according to the diagnostic utility of the combined markers. Each proposed antibody combination was tested against reference databases of normal and malignant cells from healthy subjects and WHO-based disease entities, respectively. The EuroFlow studies resulted in validated and flexible 8-color antibody panels for multidimensional identification and characterization of normal and aberrant cells, optimally suited for immunophenotypic screening and classification of hematological malignancies.
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Affiliation(s)
- J J M van Dongen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam (Erasmus MC), Rotterdam, The Netherlands.
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Park J, Han K. Single-color multitarget flow cytometry using monoclonal antibodies labeled with different intensities of the same fluorochrome. Ann Lab Med 2012; 32:171-6. [PMID: 22563550 PMCID: PMC3339295 DOI: 10.3343/alm.2012.32.3.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 01/02/2012] [Accepted: 02/01/2012] [Indexed: 11/19/2022] Open
Abstract
Background We developed a single-color multitarget flow cytometry (SM-FC) assay, a single-tube assay with graded mean fluorescence intensities (MFIs). We evaluated the repeatability of SM-FC, and its correlation with multicolor flow cytometry (MFC), to assess its application as a routine FC assay. Methods We selected CD19, CD3, CD4, and CD8 as antigen targets to analyze a lymphocyte subset. MFIs were graded by adjusting monoclonal antibody (mAb) volumes to detect several cell populations. Dimly labeled mAb was prepared by decreasing mAb volume and the optimum diluted volume was determined by serial dilution. SM-FC repeatability was analyzed 10 times in 2 normal controls. The correlation between SM-FC and MFC was evaluated in 20 normal and 23 patient samples. Results CV values (0.8-5.0% and 1.3-4.1% in samples 1 and 2, respectively) acquired by SM-FC with CD3-fluorescein α-isothyocyanate (FITC)dim+CD4-FITCbright and with CD19-FITCdim+CD3-FITCbright showed good repeatability, comparable to that acquired by MFC (1.6-3.7% and 1.0-4.8% in samples 1 and 2, respectively). Excellent correlation was observed between the 2 methods in the 20 normal samples (B cells, T cells, non-Thelper cells, and Thelper cells; r2=0.87, 0.97, 0.97, and 0.98, respectively; P<0.05). There were also linear relationships between SM-FC with CD19-FITCdim+CD3-FITCbright and CD8-PEdim+CD4-PEbright, and MFC, in the 23 patient samples (B cells, T cells, Tcytotoxic cells, and Thelper cells; r2≥0.98, 0.99, 0.99, and 0.99, respectively; P<0.05). Conclusions The multicolor, single-tube SM-FC technique is a potential alternative tool for identifying a lymphocyte subset.
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Affiliation(s)
- Joonhong Park
- Department of Laboratory Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea
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Szczepanski T, van der Velden VHJ, Waanders E, Kuiper RP, Van Vlierberghe P, Gruhn B, Eckert C, Panzer-Grümayer R, Basso G, Cavé H, Stadt UZ, Campana D, Schrauder A, Sutton R, van Wering E, Meijerink JPP, van Dongen JJM. Late recurrence of childhood T-cell acute lymphoblastic leukemia frequently represents a second leukemia rather than a relapse: first evidence for genetic predisposition. J Clin Oncol 2011; 29:1643-9. [PMID: 21357790 DOI: 10.1200/jco.2010.30.2877] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Relapse of childhood T-cell acute lymphoblastic leukemia (T-ALL) often occurs during treatment, but in some cases, leukemia re-emerges off therapy. On the basis of previous analyses of T-cell receptor (TCR) gene rearrangement patterns, we hypothesized that some late recurrences of T-ALL might in fact represent second leukemias. PATIENTS AND METHODS In 22 patients with T-ALL who had late relapses (at least 2.5 years from diagnosis), we studied TCR gene rearrangement status at first and second presentation, NOTCH1 gene mutations, and the presence of the SIL-TAL1 gene fusion. We performed genome-wide copy number and homozygosity analysis by using oligonucleotide- and single nucleotide polymorphism (SNP) -based arrays. RESULTS We found evidence of a common clonal origin between diagnosis and relapse in 14 patients (64%). This was based on concordant TCR gene rearrangements (12 patients) or concordant genetic aberrations, as revealed by genome-wide copy number analysis (two patients). In the remaining eight patients (36%), TCR gene rearrangement sequences had completely changed between diagnosis and relapse, and gene copy number analysis showed markedly different patterns of genomic aberrations, suggesting a second T-ALL rather than a resurgence of the original clone. Moreover, NOTCH1 mutation patterns were different at diagnosis and relapse in five of these eight patients. In one patient with a second T-ALL, SNP analysis revealed a germline del(11)(p12;p13), a known recurrent aberration in T-ALL. CONCLUSION More than one third of late T-ALL recurrences are, in fact, second leukemias. Germline genetic abnormalities might contribute to the susceptibility of some patients to develop T-ALL.
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Affiliation(s)
- Tomasz Szczepanski
- Erasmus Medical Center, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
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Flow cytometry and polymerase chain reaction-based analyses of minimal residual disease in chronic lymphocytic leukemia. Adv Hematol 2010; 2010. [PMID: 20886004 PMCID: PMC2945647 DOI: 10.1155/2010/272517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 07/09/2010] [Accepted: 07/30/2010] [Indexed: 12/21/2022] Open
Abstract
New therapeutic strategies developed recently for chronic lymphocytic leukemia (CLL) have led to remarkable treatment response rates and complete hematological remissions. This means highly sensitive and specific techniques are increasingly needed to evaluate minimal residual disease (MRD) in CLL patients. Quantitative MRD levels can be used as prognostic markers, where total MRD eradication is associated with prolonged survival. Nowadays, PCR and flow cytometry techniques used to detect MRD in CLL patients can generate reliable and quantitative results with the highest sensitivity. MRD Flow is based on four-color flow cytometry using specific antibody combinations. For allele specific oligonucleotide real-time quantification (ASO RQ) PCR individual primers are designed to detect a specific immunoglobulin heavy chain (IgH) rearrangement in each patient clone. Five comprehensive studies investigated and compared the sensitivity and specificity of both methods. Groups of patients receiving different therapies were analyzed at different time points to generate quantitative MRD levels and MRD kinetics. All studies confirmed that both methods generate equivalent results with regard to sensitivity and MRD quantification, although each method has advantages and disadvantages in the daily routine of a standard hematological laboratory. Here, we review these investigations and compare their results in the light of modern therapies.
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CD11b is a therapy resistance- and minimal residual disease-specific marker in precursor B-cell acute lymphoblastic leukemia. Blood 2010; 115:3763-71. [PMID: 20228269 DOI: 10.1182/blood-2009-10-247585] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
A consistently increased mRNA expression of the adhesion receptor CD11b is a hallmark of the reported genomewide gene expression changes in precursor B-cell acute lymphoblastic leukemia (PBC-ALL) after 1 week of induction therapy. To investigate its clinical relevance, CD11b protein expression in leukemic blasts has been prospectively measured at diagnosis (159 patients) and during therapy (53 patients). The initially heterogeneous expression of CD11b inversely correlated with cytoreduction rates measured at clinically significant time points of induction therapy in the ALL-Berlin-Frankfurt-Münster 2000 protocol. CD11b positivity conferred a 5-fold increased risk of minimal residual disease (MRD) after induction therapy (day 33) and of high-risk group assignment after consolidation therapy (day 78). In the multivariate analysis CD11b expression was an independent prognostic factor compared with other clinically relevant parameters at diagnosis. During therapy, CD11b expression increased early in most ALL cases and remained consistently increased during induction/consolidation therapy. In more than 30% of MRD-positive cases, the CD11b expression on blast cells exceeded that of mature memory B cells and improved the discrimination of residual leukemic cells from regenerating bone marrow. Taken together, CD11b expression has considerable implications for prognosis, treatment response monitoring, and MRD detection in childhood PBC-ALL.
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Abstract
Whereas animal studies are invaluable for screening various chemical and drugs for immunotoxic potential, such systems are necessarily limited in their predictive value for humans given the differences in physiology, immune system structure and function, and various other parameters between humans and nonhuman animals. However, prospective experimental studies in humans are not always practical or ethical. What is needed is an approach for combining animal data, human data collected in the course of clinical studies, and modern tools of bioinformatics and systems biology. In this chapter, we will explore current assays and methodologies for assessing immunotoxic potential in humans using this multi--parameter approach.
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van Gent R, van Tilburg CM, Nibbelke EE, Otto SA, Gaiser JF, Janssens-Korpela PL, Sanders EAM, Borghans JAM, Wulffraat NM, Bierings MB, Bloem AC, Tesselaar K. Refined characterization and reference values of the pediatric T- and B-cell compartments. Clin Immunol 2009; 133:95-107. [PMID: 19586803 DOI: 10.1016/j.clim.2009.05.020] [Citation(s) in RCA: 140] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Revised: 05/21/2009] [Accepted: 05/27/2009] [Indexed: 11/26/2022]
Abstract
Work in the past years has led to a refined phenotypical description of functionally distinct T- and B-cell subsets. Since both lymphocyte compartments are established and undergo dramatic changes during childhood, redefined pediatric reference values of both compartments are needed. In a cohort of 145 healthy children, aged 0-18 years, the relative and absolute numbers of the various T- and B-cell subsets were determined. In addition, we found that besides thymic output, naive (CD27(+)CD45RO(-)) T-cell proliferation contributed significantly to the establishment of the naive T-cell compartment. At birth, regulatory (CD25(+)CD127(-)CD4(+)) T cells (Tregs) mainly had a naive (CD27(+)CD45RO(-)) phenotype whereas 'memory or effector-like' (CD45RO(+)) Tregs accumulated slowly during childhood. Besides the CD27(+)IgM(+)IgD(+) memory B-cell population, the recently identified CD27(-)IgG(+) and CD27(-)IgA(+) memory B-cell populations were already present at birth. These data provide reference values of the T- and B-cell compartments during childhood for studies of immunological disorders or immune reconstitution in children.
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Affiliation(s)
- R van Gent
- Department of Immunology, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB Utrecht, The Netherlands
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Brooimans RA, Kraan J, van Putten W, Cornelissen JJ, Löwenberg B, Gratama JW. Flow cytometric differential of leukocyte populations in normal bone marrow: Influence of peripheral blood contamination1. CYTOMETRY PART B-CLINICAL CYTOMETRY 2009; 76:18-26. [DOI: 10.1002/cyto.b.20439] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Accepted: 06/04/2008] [Indexed: 11/05/2022]
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van der Velden VHJ, van Dongen JJM. MRD detection in acute lymphoblastic leukemia patients using Ig/TCR gene rearrangements as targets for real-time quantitative PCR. Methods Mol Biol 2009; 538:115-50. [PMID: 19277574 DOI: 10.1007/978-1-59745-418-6_7] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Minimal residual disease (MRD) diagnostics has proven to be clinically relevant for evaluation of treatment effectiveness in patients with acute lymphoblastic leukemia (ALL). In most ALL treatment protocols, MRD diagnostics is performed by real-time quantitative PCR (RQ-PCR) analysis of the junctional regions of rearranged immunoglobulin (Ig) and T-cell receptor (TCR) genes.MRD diagnostics via Ig/TCR genes is broadly applicable (>95% of ALL patients) and can reach a good sensitivity (< or =10 (-4)). However, the technique is complex and requires extensive knowledge and experience, because the junctional regions of each leukemia have to be identified before the patient-specific RQ-PCR assays can be designed for MRD monitoring. This chapter provides all relevant background information and technical aspects for the complete laboratory process from detection of the clonal Ig/TCR gene rearrangements in ALL cells at diagnosis to the actual MRD measurements in clinical follow-up samples. This information aims at facilitating the PCR-based MRD diagnostics in ALL patients. However, it should be noted that MRD diagnostics for clinical treatment protocols has to be accompanied by regular international quality control rounds to ensure the reproducibility and reliability of the MRD results.
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Steinbrich-Zöllner M, Grün JR, Kaiser T, Biesen R, Raba K, Wu P, Thiel A, Rudwaleit M, Sieper J, Burmester GR, Radbruch A, Grützkau A. From transcriptome to cytome: integrating cytometric profiling, multivariate cluster, and prediction analyses for a phenotypical classification of inflammatory diseases. Cytometry A 2008; 73:333-40. [PMID: 18307258 DOI: 10.1002/cyto.a.20505] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Gene expression studies of peripheral blood cells in inflammatory diseases revealed a large array of new antigens as potential biomarkers useful for diagnosis, prognosis, and therapy stratification. Generally, their validation on the protein level remains mainly restricted to a more hypothesis-driven manner. State-of-the-art multicolor flow cytometry make it attractive to validate candidate genes at the protein and single cell level combined with a detailed immunophenotyping of blood cell subsets. We developed multicolor staining panels including up to 50 different monoclonal antibodies that allowed the assessment of several hundreds of phenotypical parameters in a few milliliters of peripheral blood. Up to 10 different surface antigens were measured simultaneously by the combination of seven different fluorescence colors. In a pilot study blood samples of ankylosing spondylitis (AS) patients were compared with normal donors (ND). A special focus was set on the establishment of suitable bioinformatic strategy for storing and analyzing hundreds of phenotypical parameters obtained from a single blood sample. We could establish a set of multicolor stainings that allowed monitoring of all major leukocyte populations and their corresponding subtypes in peripheral blood. In addition, antigens involved in complement and antibody binding, cell migration, and activation were acquired. The feasibility of our cytometric profiling approach was demonstrated by a successful classification of AS samples with a reduced subset of 80 statistically significant parameters, which are partially involved in antigen presentation and cell migration. Furthermore, these parameters allowed an error-free prediction of independent AS and ND samples originally not included for parameter selection. This study demonstrates a new level of multiparametric analysis in the post-transcriptomic era. The integration of an appropriate bioinformatic solution as presented here by the combination of a custom-made Access database along with cluster- and prediction-analysis tools predestine our approach to promote the human cytome project.
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Abstract
Several studies have demonstrated that monitoring of minimal residual disease (MRD) in childhood and adult acute lymphoblastic leukemia (ALL) significantly correlates with clinical outcome. MRD detection is particularly useful for evaluation of early treatment response and consequently for improved front-line therapy stratification. MRD information is also significant for children undergoing allogeneic hematopoietic stem cell transplantation and those with relapsed ALL. Currently, three highly specific and sensitive methodologies for MRD detection are available, namely multiparameter flow cytometric immunophenotyping, real-time quantitative polymerase chain reaction (RQ-PCR)-based detection of fusion gene transcripts or breakpoints, and RQ-PCR-based detection of clonal immunoglobulin and T-cell receptor gene rearrangements. In this review, characteristics, pitfalls, advantages and disadvantages of each MRD technique are critically discussed. The special emphasis is put on interlaboratory standardization, especially in view of the results obtained within the European collaborative BIOMED-1, BIOMED-2, and Europe Against Cancer projects and recent developments by European Study Group on MRD detection in ALL and EuroFlow Consortium. Standardized MRD techniques form the basis for stratification of patients into the risk groups in new treatment protocols mainly in childhood ALL. Only the results of these studies can answer the question whether MRD-based treatment intervention is associated with improved outcome.
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Affiliation(s)
- T Szczepański
- Department of Pediatric Hematology and Oncology, Silesian Medical Academy, Zabrze, Poland.
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