CD38 and CD58: A Gallant Savior in Under-Resourced Laboratories

Background B-cell acute lymphoblastic leukemia (B-ALL) is one of the most common childhood malignancies and comprises almost the majority of acute leukemias in children. At the end of induction, minimal residual disease (MRD) is one of the most important prognostic indicators. MRD is commonly detected by multiparametric flow cytometry. Interpreting panels consisting of multiple tubes requires a lot of expertise and is subject to stringent standardization processes. Hence, there arises a need for an easier alternative that can be more universally applicable and reduce complexity in interpretation, resulting in uniform reporting and cost-effectiveness, especially in resource-deficient settings, without compromising clinical outcomes. Therefore, the aim is to find the usefulness of the MRD "lite" panel for post-induction MRD detection in pediatric B-ALL using CD38, CD10, CD34, CD19, and CD45 compared to the "standard tube" panel. Methods The study included 25 children diagnosed with B-ALL and undergoing treatment. MRD detection was performed on day 28 of post-induction chemotherapy using a standard tube panel consisting of three tubes (gold standard) and our single tube MRD "lite" panel. The results obtained by the two were compared. Results The sensitivity and specificity of the MRD "lite" panel were calculated as 100% and 84.2%, respectively, taking the standard tube panel as the gold standard. CD10, CD20, and CD200 were valuable in distinguishing MRD-positive cases from MRD-negative cases. Moreover, the MRD "lite" panel had 100% concordance between the two observers, suggesting simplicity in assessment and, hence, wider applicability.