Multiparametric Flow Cytometry for MRD Monitoring in Hematologic Malignancies: Clinical Applications and New Challenges
Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470441/
Andrei Tchirkov, Academic Editor Keywords: MRD, flow cytometry, immunophenotype, leukemia, myeloma, lymphoma, immunotherapy Since the last decades of the past century, the development of affordable and sensitive methods to identify rare leukemic cells, still detectable-at very low levels-either in the bone marrow (BM) or in the peripheral blood (PB) of hematologic patients on post-treatment follow-up, has provided a striking improvement of our ability to quantify the resistant/recurrent disease burden, far beyond morphologic remission (i.e., below the conventional microscopy threshold of 1 out of 100 cells).
• Source: Cancers
• Conclusion/Relevance: “In this paper, we outlined the state-of-the-art of MFC-based MRD detection in different hematologic settings, highlighting main recommendations and new challenges for using such method in patients with acute leukemias or chronic hematologic neoplasms. The combination of new molecular technologies with advanced flow cytometry is progressively allowing clinicians to design a personalized therapeutic path, proportionate to the biological aggressiveness of the disease, in particular by using novel immunotherapies, in view of a modern decision-making process, based on precision medicine.”
• In the context of blood cancers, minimal residual disease (MRD) monitoring relies on either molecular (PCR) or immunophenotypic (MFC) diagnostics for the detection of very low levels of rare blood cancer cells in the bone marrow or in the peripheral blood, per the authors. MFC detects the abnormal expression of specific antigens, whereas molecular diagnostics such as PCR entail genetic analysis to detect specific DNA signatures.
• The authors noted that the MFC-MRD strategy is necessary to assess expression levels and clonal patterns of specific surface antigens that can be targeted by novel immunotherapies such as monoclonal antibodies and CAR-T cells. In comparison with other molecular MRD methods, the authors noted that MFC-based MRD detection currently is somewhat less sensitive, but faster and more accessible in the vast majority of patients, in addition to being cost-effective.