Related Experiment Video
Updated: Sep 20, 2025
Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
Published on: March 26, 2018
Ultrasensitive detection of circulating multiple myeloma cells by next-generation flow after immunomagnetic
Marta Lasa1, Carmen Gonzalez1, Laura Notarfranchi1,2
1Cancer Center Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada, Instituto de Investigacion Sanitaria de Navarra, CIBERONC CB16/12/00369 and CB16/12/00489, Pamplona, Spain.
Abstract:
The continuous improvement in progression-free survival (PFS) of patients with multiple myeloma (MM) raises interest in evaluating peripheral residual disease (PRD) toward more frequent readouts of tumor kinetics while preserving quality of life. We present BloodFlow, a new method combining immunomagnetic enrichment of CD138+ circulating plasma cells in peripheral blood (PB) with next-generation flow (NGF), for the detection of PRD below the 2 × 10-6 NGF threshold. BloodFlow detected PRD in 55 of 644 PB samples (8.5%) from 295 patients. Of note, 52.7% PB samples were positive using BloodFlow and negative by NGF. The lowest PRD detected by BloodFlow was 6 × 10-8. Using bone marrow measurable residual disease (MRD) status as the reference, BloodFlow showed positive and negative predictive values of 95.1% and 76.6%, respectively. Detectable PRD during maintenance or observation predicted dismal PFS and overall survival (2-year rates of 0% and 62%, respectively). BloodFlow surpassed NGF in PB and retained independent prognostic value for PFS in multivariate analysis, including transplant eligibility, the revised International Staging System, complete remission, and MRD status. BloodFlow is the first flow cytometry method that detects tumor cells below the 10-6 threshold, enabling improved minimally invasive monitoring of patients with MM.
