Flow Cytometric Detection of Residual Cells in B-ALL
The prognostic importance of MRD detected by multiparametric flow cytometry (MFC) in children and adult affected by ALL has been clearly demonstrated. MRD detection by MFC relies on identification of “leukemia-associated immunophenotypes” (LAIPs), defined as a combination of antigens and/or flow cytometric physical abnormalities that are absent or very infrequent in normal bone marrow.
The simultaneous analysis of several different parameters (2 scatter parameters and a variable number related to the immunophenotype) contributes to increasing both the specificity and the sensitivity of the test with precise identification of cellular subsets and characterization of rare subsets. Using up to 12 parameters panels can be reduced from multiple tubes to one tube allowing important information to be collected from even small sample volumes. MFC is applicable for MRD monitoring in ~95% of ALL patients with a sensitivity of 10-4.
Speed of blast clearance is an indicator of outcome in childhood acute lymphoblastic leukemia (ALL) while MFC data obtained during and at the end of induction are useful for stratification purposes. In particular, in an AIEOP-BFM collaborative study MFC measurement of MRD in day 15 bone marrow was the most powerful early predictor of relapse, applicable to virtually all patients. Thus, MRD analysis by MFC contributes to early identification of low and high risk patients, opening new perspectives for innovative therapeutic strategies.
Presented by
Professor Giuseppe Basso,
Professor Giuseppe Basso’s research interest have always dealt with hematological neoplasms of
childhood, in particular, acute lymphoblastic and acute myeloid leukemias. His field of work includes all steps of laboratory work-up for diagnosis of leukemias, particularly flow cytometry for immunophenotyping, ploidy and functional studies.
Since 1990 he has been in charge of the Biological Bank for acute leukemias of the AIEOP (Italian Association for Pediatric Hematology and Oncology) and is responsible for centralized diagnosis of all cases entering the Italian therapeutic protocols.
He is also member of many international committees on pediatric leukemias, solid tumors and hepatoblastomas biology as well as the author of more than 240 peer reviewer publications.
