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Updated: Mar 26, 2026
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
Advances and issues in flow cytometric detection of immunophenotypic changes and genomic rearrangements in acute
1Flow Cytometry Centre, Westmead Millennium Institute, Westmead, NSW, Australia.
Insights
Flow cytometry is crucial for diagnosing childhood leukemia, aiding in characterization, prognosis, and targeted therapy decisions. This technology helps identify leukemia cells and monitor minimal residual disease (MRD).
Area of Science:
- Hematology
- Immunology
- Cell Biology
Background:
- Flow cytometry has been instrumental in diagnosing hematological disorders for over 20 years.
- It is the primary technology for childhood leukemia diagnosis, characterization, prognosis, and guiding targeted therapies.
- Leukemia cells are identified by unique cell marker combinations using monoclonal antibodies and flow cytometry.
Purpose of the Study:
- To review the latest advancements in flow cytometric diagnostic and prognostic applications for acute pediatric leukemia.
- To discuss current issues and applications of flow cytometry in pediatric leukemia management.
Main Methods:
- Utilizing multi-marker detection (eight or more) for comprehensive leukemic cell phenotype description.
- Employing flow cytometric DNA index (DI) to identify biclonality and persistent aneuploid leukemia.
- Leveraging flow cytometry for detecting and monitoring minimal residual disease (MRD) during treatment.
Main Results:
- Flow cytometry enables precise identification of leukemia cell phenotypes.
- It facilitates the detection and monitoring of minimal residual disease (MRD).
- The DNA index (DI) aids in identifying biclonality and persistent aneuploid leukemia when other methods fail.
Conclusions:
- Flow cytometry is indispensable for acute pediatric leukemia diagnosis and management.
- Its multi-marker capabilities and DNA index analysis offer significant advantages in characterization and monitoring.
- Continued advancements enhance its role in targeted therapy and prognosis prediction.
Abstract:
Flow cytometry with its rapidly increasing applications has been using to aid the diagnosis of hematological disorders for more than two decades. It is also the most commonly used technology in childhood leukaemia diagnosis, characterization, prognosis prediction and even in the decision making of targeted therapy. Leukemia cells can be recognized by virtue of unique cell marker combinations, visualized with monoclonal antibodies conjugated and detected by flow cytometry. Currently, such instruments allow the detection of eight or more markers by providing a comprehensive description of the leukemic cell phenotype to facilitate their identification, especially in detecting and monitoring of minimal residual disease (MRD) during treatment. Additionally, the flow cytometric DNA index (DI) can identify biclonality at diagnosis and distinguish persistent aneuploid leukemia during induction therapy, when the standard cytogenetic and morphologic techniques fail to do so. This review focuses on the latest advances and application issues about some of flow cytometric diagnostic and prognostic applications for acute pediatric leukemia.
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