Applications and efficiency of flow cytometry for leukemia diagnostics
Maria Ilaria Del Principe1,2, Eleonora De Bellis1,2, Carmelo Gurnari1,2
1Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Roma, Italia.
Insights
Multiparametric flow cytometry immunophenotype (MFCI) is essential for diagnosing acute leukemia (AL) and its subtypes. MFCI also aids in detecting minimal residual disease, guiding personalized treatment strategies.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Multiparametric flow cytometry immunophenotype (MFCI) is vital for acute leukemia (AL) diagnosis.
- MFCI distinguishes between myeloid, lymphoid, and ambiguous lineage AL by analyzing blast antigens.
- It is applicable to bone marrow, peripheral blood, and cerebrospinal fluid samples.
Purpose of the Study:
- To review the current diagnostic applications of MFCI in acute leukemia.
- To highlight MFCI's role in diagnosing central nervous system leukemic involvement.
- To discuss MFCI's prognostic value and utility in assessing measurable residual disease.
Main Methods:
- Comprehensive review of current literature on MFCI in AL diagnosis.
- Focus on specific applications, including CNS involvement and residual disease detection.
- Analysis of MFCI's contribution to prognostic information.
Main Results:
- MFCI remains a cornerstone for prompt and accurate AL diagnosis.
- MFCI provides prognostic information through antigen expression linked to genetic abnormalities.
- MFCI is a powerful tool for evaluating measurable residual disease, influencing treatment decisions.
Conclusions:
- MFCI is indispensable for acute leukemia diagnosis and subtyping.
- Its role extends to detecting central nervous system involvement and assessing treatment response.
- MFCI's ability to detect minimal residual disease impacts prognostic assessment and personalized interventions.
Abstract:
Introduction: Multiparametric flow cytometry immunophenotype (MFCI) plays a crucial role in the diagnosis of acute leukemia (AL). Through the comprehensive assessment of surface and intracellular antigens expressed by blasts, MFCI permits to distinguish myeloid or B/T lymphoid AL, or AL of ambiguous lineages. By means of MFCI, the blasts can be characterized in bone marrow, peripheral blood, and body fluids, such as cerebrospinal fluid.Area covered: This review discusses how MFCI is currently applied in the diagnostic evaluation of AL; it also focuses on 'peculiar' issues such as the role of MFCI for the diagnosis of central nervous system leukemic involvement.Expert commentary: Despite the improved knowledge about the biology of AL, MFCI remains a fundamental tool to make a prompt and accurate diagnosis. MFCI also provides prognostic information for some antigens are associated with specific cytogenetic/genetic abnormalities and, recently, it became a powerful tool to evaluate the quality and depth of response (the so called 'measurable residual disease'). Its role as an efficient detector of residual disease paved the way to the investigation of tissues other than bone marrow and peripheral blood, demonstrating that even small amounts of AL appear to have a prognostic impact and may require personalized intervention.
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