Consensus guidelines for myeloma minimal residual disease sample staining and data acquisition

Area of Science:

• Clinical cytometry
• Hematologic oncology
• Immunophenotyping

Background:

• Flow cytometry (FC) is crucial for detecting minimal residual disease (MRD) in multiple myeloma (MM), impacting prognosis and treatment response.
• Standardization of FC-based MRD testing is essential for uniform patient assessment and prognostication.
• The International Clinical Cytometry Society and European Society for Clinical Cell Analysis developed consensus guidelines for FC MM MRD testing.

Purpose of the Study:

• To establish consensus guidelines for good clinical practice in FC MM MRD testing.
• To standardize specimen quality, staining, reagents, and data acquisition for reliable FC MM MRD detection.
• To ensure uniform assessment of therapy response and clinical prognostication in MM patients.

Main Methods:

• A working group of eight experienced flow cytometrists evaluated existing literature on FC MM MRD testing.
• Best practice recommendations were developed through iterative review and consensus-building.
• Guidelines were formulated covering specimen quality, staining, reagent panels, and data acquisition.

Main Results:

• Consensus was reached on a standardized panel for MRD detection in MM.
• Specific antibody combinations were recommended for optimal FC MM MRD analysis.
• Guidelines for specimen handling, staining protocols, and data acquisition were established.

Conclusions:

• Standardized FC MM MRD testing, utilizing recommended antibody panels (CD38, CD138, CD45 with CD19, CD56, CD27, CD81, CD117), improves diagnostic accuracy.
• Consensus guidelines address critical factors for high-quality FC MM MRD testing.
• Adherence to these guidelines facilitates consistent and reliable assessment of MRD in multiple myeloma.