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Related Concept Videos

Flow Cytometry01:23

Flow Cytometry

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The development of flow cytometry techniques began in 1934 with initial attempts by Andrew Moldavan, a bacteriologist who counted the cells in a flowing capillary system. Moldavan pumped cells through a capillary tube focused under a microscope for visualization. The invention of photometry allowed the measurement of differentially-stained cells, and Louis Kamentsky developed the first multiparameter flow cytometer in 1965 to identify and count the cancer cells in cervical tissue specimens.
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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
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Measurable Residual Disease Assessment in B-Lymphoblastic Leukemia Using 5- and 10-Color Flow Cytometry: An

Anand V Narayanan1, Mohandoss Murugesan2, Chandran Nair3

  • 1Oncopathology, Malabar Cancer Centre, Kannur, IND.

Cureus
|February 18, 2026
PubMed
Summary

Five-color flow cytometry offers practical measurable residual disease (MRD) assessment in B-lymphoblastic leukemia (B-ALL). Ten-color flow cytometry provides enhanced immunophenotypic detail and better detection of low-level MRD, supporting its routine use alongside morphology.

Keywords:
b-allflow cytometryimmunophenotypemrdpost-induction

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Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Measurable residual disease (MRD) assessment is crucial for B-lymphoblastic leukemia (B-ALL) prognosis.
  • Advances in multicolor flow cytometry enhance MRD detection capabilities.
  • Limited real-world data exists comparing 5-color and 10-color flow cytometry for MRD assessment in B-ALL.

Purpose of the Study:

  • To compare MRD detection efficacy between 5-color and 10-color flow cytometry in B-ALL.
  • To evaluate leukemia-associated immunophenotype (LAIP) expression patterns and concordance with morphology.
  • To assess the impact of flow cytometry panel size on MRD detection and characterization.

Main Methods:

  • Retrospective analysis of 172 paired B-ALL samples (2018-2024).
  • MRD evaluation using predefined LAIPs on 5-color (lower event acquisition) and 10-color (higher event acquisition) platforms.
  • MRD positivity defined as ≥10 clustered aberrant events with abnormal antigen expression.

Main Results:

  • Overall MRD positivity rates were similar: 23.5% (5-color) and 21.5% (10-color).
  • CD58 overexpression was the most reproducible LAIP on both platforms.
  • 10-color cytometry revealed finer antigen shifts and lower MRD detection limits, with >2/3 of MRD+ cases negative by morphology.

Conclusions:

  • Five-color flow cytometry is practical for MRD assessment in B-ALL.
  • Ten-color flow cytometry offers superior immunophenotypic detail and improved low-level MRD detection.
  • Routine MRD evaluation by flow cytometry alongside morphology is recommended for post-induction assessment and risk-adapted management in B-ALL.