微小残留病
医学
CD5型
CD19
慢性淋巴细胞白血病
肿瘤科
内科学
一致性
流式细胞术
免疫学
白血病
作者
Andy C. Rawstron,Sebastian Böttcher,Rémi Letestu,Neus Villamor,Claudia Fazi,H. Kartsios,Ruth M. de Tute,Jane Shingles,Matthias Ritgen,Carol Moreno,Ke Lin,Andrew R. Pettitt,Michael Kneba,Emili Montserrat,Florence Cymbalista,Michael Hallek,Peter Hillmen,Paolo Ghia
出处
期刊:Leukemia
[Springer Nature]
日期:2012-07-31
卷期号:27 (1): 142-149
被引量:168
摘要
Detection of minimal residual disease (MRD) in chronic lymphocytic leukaemia (CLL) is becoming increasingly important as treatments improve. An internationally harmonised four-colour (CLR) flow cytometry MRD assay is widely used but has limitations. The aim of this study was to improve MRD analysis by identifying situations where a less time-consuming CD19/CD5/κ/λ analysis would be sufficient for detecting residual CLL, and develop a six-CLR antibody panel that is more efficient for cases requiring full MRD analysis. In 784 samples from CLL patients after treatment, it was possible to determine CD19/CD5/κ/λ thresholds that identified cases with detectable MRD with 100% positive predictive value (PPV). However, CD19/CD5/κ/λ analysis was unsuitable for predicting iwCLL/NCI response status or identifying cases with no detectable MRD. For the latter cases requiring a full MRD assessment, a six-CLR assay was designed comprising CD19/CD5/CD20 with (1) CD3/CD38/CD79b and (2) CD81/CD22/CD43. There was good correlation between four-CLR and six-CLR panels in dilution studies and clinical samples, with 100% concordance for detection of residual disease at the 0.01% (10−4) level (n=59) and good linearity even at the 0.001–0.01% (10−5–10−4) level. A six-CLR panel therefore provides equivalent results to the four-CLR panel but it requires fewer reagents, fewer cells and a much simpler analysis approach.
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