Detecting minimal residual disease in patients with chronic lymphocytic leukemia using 8-color flow cytometry protocol in routine hematological practice

2013 ◽  
Vol 36 (2) ◽  
pp. 165-171 ◽  
Author(s):  
O. Stehlíková ◽  
J. Chovancová ◽  
B. Tichý ◽  
M. Krejčí ◽  
Y. Brychtová ◽  
...  
2020 ◽  
pp. 19-24
Author(s):  
Yu. V. Mirolyubova ◽  
N. S. Timofeeva ◽  
V. A. Bart ◽  
V. M. Solovyov ◽  
E. V. Tolstopyatova ◽  
...  

Background and Aims. The detection of minimal residual disease (MRD) of chronic lymphocytic leukemia (CLL) using multicolor flow cytometry has been widely used in clinical studies to evaluate the effectiveness of treatment. The method is being improved by searching for the most sensitive and specific markers for use in panels for 6–8 color cytometers. According to published data, ROR1 shows high expression on CLL cells, and lack of expression on mature lymphocytes, which distinguishes it from other markers used to detect MRD in CLL.Aim: to determine a significance of ROR1 for detection of MRD CLL by flow cytometry in a 4-color panel.Materials and Methods. We analyzed 64 bone marrow samples of 37 patients with a verified diagnosis of CLL after the 3rd and 6th cycles of therapy according to bendamustine and rituximab (BR) regimen – 15 MRD-negative and 49 MRD-positive. Quantitative determination of MRD was carried out by the standardized method of 4-color flow cytometry according to the recommendations of ERIC (European research initiative on CLL) with the inclusion of ROR1 in the diagnostic panel. A discriminatory analysis of the differentiating properties of diagnostic markers was performed using Statistica 10.Results. ROR1 has demonstrated high differentiating properties on CLL cells and mature lymphocytes. All the analyzed samples showed a bright monomorphic expression of ROR1 on CLL cells and B-cell precursors, and the absence of its expression on mature lymphocytes.Conclusion. ROR1 is a highly specific and sensitive marker for the detection of CLL cells among mature lymphocytes. The high expression of ROR1 on normal B-cell precursors requires the use of ROR1 in combination with a marker that differentiates CLL cells from progenitor cells (CD81).


2010 ◽  
Vol 2010 ◽  
pp. 1-11 ◽  
Author(s):  
Sabrina Uhrmacher ◽  
Felix Erdfelder ◽  
Karl-Anton Kreuzer

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.


2021 ◽  
pp. 1-8
Author(s):  
Alexandre Bazinet ◽  
Ryan N. Rys ◽  
Amadou Barry ◽  
Celia M. T. Greenwood ◽  
Yoon Kow Young ◽  
...  

Blood ◽  
2006 ◽  
Vol 109 (2) ◽  
pp. 405-411 ◽  
Author(s):  
Neil E. Kay ◽  
Susan M. Geyer ◽  
Timothy G. Call ◽  
Tait D. Shanafelt ◽  
Clive S. Zent ◽  
...  

Abstract Building on the prior work of use of pentostatin in chronic lymphocytic leukemia (CLL), we initiated a trial of combined pentostatin (2 mg/m2), cyclophosphamide (600 mg/m2), and rituximab (375 mg/m2) for 65 symptomatic, previously untreated patients. Of 64 evaluable patients, 34 (53%) were high Rai risk, 71% were nonmutated for the immunoglobulin heavy-chain variable region gene, 34% were CD38+, and 34% were ZAP-70+. Thirty patients (52%) had one anomaly detected by fluorescence in situ (FISH) hybridization, and 21 (36%) had complex FISH defects. Thirty-eight patients (58%) had grade 3+ hematologic toxicity but minimal transfusion needs and no major infections. Responses occurred in 58 patients (91%), with 26 (41%) complete responses (CRs), 14 (22%) nodular partial responses (nodular PRs), and 18 (28%) partial responses (PRs). Many patients with a CR also lacked evidence of minimal residual disease by 2-color flow cytometry. Examination of prognostic factors demonstrated poor response in the 3 patients with del(17p). In contrast, we found this regimen was equally effective in young versus older (> 70 years) patients and in del(11q22.3) versus other favorable prognostic factors. Thus, this novel regimen of pentostatin, cyclophosphamide, and rituximab for previously untreated patients with CLL demonstrated significant clinical activity despite poor risk-based prognoses, achievement of minimal residual disease in some, and modest toxicity.


2015 ◽  
Vol 139 (10) ◽  
pp. 1276-1280 ◽  
Author(s):  
Michael Keeney ◽  
Jaimie G. Halley ◽  
Daniel D. Rhoads ◽  
M. Qasim Ansari ◽  
Steven J. Kussick ◽  
...  

Context Flow cytometry is often applied to minimal residual disease (MRD) testing in hematolymphoid neoplasia. Because flow-based MRD tests are developed in the laboratory, testing methodologies and lower levels of detection (LODs) are laboratory dependent. Objectives To broadly survey flow cytometry laboratories about MRD testing in laboratories, if performed, including indications and reported LODs. Design Voluntary supplemental questions were sent to the 549 laboratories participating in the College of American Pathologists (CAP) FL3-A Survey (Flow Cytometry—Immunophenotypic Characterization of Leukemia/Lymphoma) in the spring of 2014. Results A total of 500 laboratories (91%) responded to the supplemental questions as part of the FL3-A Survey by April 2014; of those 500 laboratories, 167 (33%) currently perform MRD for lymphoblastic leukemia, 118 (24%) for myeloid leukemia, 99 (20%) for chronic lymphocytic leukemia, and 91 (18%) for plasma cell myeloma. Other indications include non-Hodgkin lymphoma, hairy cell leukemia, neuroblastoma, and myelodysplastic syndrome. Most responding laboratories that perform MRD for lymphoblastic leukemia reported an LOD of 0.01%. For myeloid leukemia, chronic lymphocytic leukemia, and plasma cell myeloma, most laboratories indicated an LOD of 0.1%. Less than 3% (15 of 500) of laboratories reported LODs of 0.001% for one or more MRD assays performed. Conclusions There is major heterogeneity in the reported LODs of MRD testing performed by laboratories subscribing to the CAP FL3-A Survey. To address that heterogeneity, changes to the Flow Cytometry Checklist for the CAP Laboratory Accreditation Program are suggested that will include new requirements that each laboratory (1) document how an MRD assay's LOD is measured, and (2) include the LOD or lower limit of enumeration for flow-based MRD assays in the final diagnostic report.


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