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Flow Cytometry

Flow Cytometry

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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Using flow cytometry for paediatric leukaemia diagnosis in Kenya: a protocol for mixed methods study.

Tyler Severance¹, Teresa Lotodo², Enock Serem³

¹Department of Pediatrics, University of Missouri School of Medicine, Columbia, Missouri, USA.

|March 20, 2026

Summary

A new streamlined flow cytometry assay shows promise for improving childhood leukaemia diagnosis in Kenya. This method, combined with a regional educational program, aims to overcome barriers to accurate cancer detection in low-resource settings.

Keywords:

Early Detection of Cancer Feasibility Studies Haematopathology Leukaemia ONCOLOGY PUBLIC HEALTH

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Area of Science:

Hematology
Oncology
Medical Diagnostics

Background:

Childhood cancer diagnosis in western Kenya faces significant delays, with leukaemia being a major concern.
Flow cytometry is crucial for leukaemia diagnosis but is underutilized in sub-Saharan Africa due to cost, equipment, and training limitations.
Existing cytometers in Kenya are outdated, necessitating the exploration of newer, more sustainable diagnostic platforms.

Purpose of the Study:

To evaluate the diagnostic accuracy of a streamlined, single-tube flow cytometry assay compared to a standard multi-tube assay.
To assess the feasibility of implementing this assay within a referral system using peripheral blood samples.
To measure the effectiveness of a regional educational initiative on improving diagnostic knowledge and skills.

Main Methods:

A prospective, mixed-methods study comparing a 1-tube assay (ClearLLab LS) with a 4-tube assay (ClearLLab 10C) using paired bone marrow and peripheral blood samples.
Evaluating the logistics of transporting peripheral blood samples from referral sites across western Kenya.
Assessing training effectiveness via surveys, knowledge tests, and interviews using the Project ECHO model.

Main Results:

The study aims to measure diagnostic concordance, sensitivity, and specificity between the two flow cytometry assays.
Feasibility of sample transport and referral logistics will be quantitatively and qualitatively assessed.
The impact of the educational program on participants' knowledge gain will be measured.

Conclusions:

This research protocol outlines a strategy to implement and evaluate a simplified flow cytometry assay for improved leukaemia diagnosis in Kenya.
The study seeks to enhance diagnostic capacity and address critical gaps in childhood cancer care in low-resource settings.
Findings will inform the scalable and sustainable integration of advanced diagnostic tools in regional healthcare.