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Detection of Minimal Residual Disease in B Cell Acute CORE Metadata, citation and similar papers at core.ac.uk Provided by Archive Ouverte en Sciences de l'Information et de la Communication Detection of Minimal Residual Disease in B Cell Acute Lymphoblastic Leukemia Using an Eight-Color Tube with Dried Antibody Reagents Lakhdar Bouriche, Denis Bernot, Vanessa Nivaggioni, Isabelle Arnoux, Marie Loosveld To cite this version: Lakhdar Bouriche, Denis Bernot, Vanessa Nivaggioni, Isabelle Arnoux, Marie Loosveld. Detection of Minimal Residual Disease in B Cell Acute Lymphoblastic Leukemia Using an Eight-Color Tube with Dried Antibody Reagents. CYTOMETRY PART B-CLINICAL CYTOMETRY, 2019, 96 (2), pp.158-163. 10.1002/cyto.b.21766. hal-02359455 HAL Id: hal-02359455 https://hal.archives-ouvertes.fr/hal-02359455 Submitted on 13 Feb 2020 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Cytometry Part B (Clinical Cytometry) 96B:158–163 (2019) Brief Communication Detection of Minimal Residual Disease in B Cell Acute Lymphoblastic Leukemia Using an Eight-Color Tube with Dried Antibody Reagents Lakhdar Bouriche,1 Denis Bernot,1 Vanessa Nivaggioni,1 Isabelle Arnoux,1 and Marie Loosveld1,2* 1Assistance Publique Hôpitaux de Marseille, Laboratoire d’Hématologie, Hôpital de la Timone, Marseille, France 2CNRS, INSERM, CIML, Aix Marseille University, Marseille, France Background: Flow cytometry is a powerful tool for the detection of minimal residual disease (MRD) of B cell precursor acute lymphoblastic leukemia (BCP-ALL) patients. However, the staining process and the choice of antibodies rely on laboratory expertise and may be source of variability or technical errors. Recently, Beckman Coulter commercialized a ready to use tube with dried format reagents for BCP-ALL MRD detection. The aim of this study is to evaluate the applicability of this tube and to compare it to a conventional (liquid format reagents) method. Methods: Thirty-one samples from B ALL patients were analyzed: 19 bone marrow (BM) aspirations, 10 peripheral blood (PB) samples and 2 cerebrospinal fluids at different stages of the follow-up. In addition, we tested 5 bone marrow samples mixed into non-pathological (control) bone marrow. The dried format tube included seven antibodies: CD45Kro, CD58FITC, CD34ECD, CD10PC5.5, CD19PC7, CD38AA700, CD20AA750, with possibility of additional antibodies for blast markers identified at diagnosis. For comparison, a liquid for- mat tube was prepared, and considered as the reference. Results: This tube was validated for daily routine laboratory, with satisfying qualitative (MRD + or MRD−) and quantitative (MRD percentages) correlation with the reference tube. Conclusion: With this single dried format tube, we showed interesting results for BCP-ALL MRD detection in the aim of standardization and reliable interlaboratory results. It allows accurate MRD detection including low levels (10–4), and offers possibility to increase performance (supplementary antibody) within a preestablished effective antibody panel for BCP-ALL MRD. © 2019 International Clinical Cytometry Society Key terms: flow cytometry; B cell acute lymphoblastic leukemia; minimal residual disease detection; Dura- clone; dried reagents. How to cite this article: Bouriche L, Bernot D, Nivaggioni V, Arnoux I, and Loosveld M. Detection of Mini- mal Residual Disease in B Cell Acute Lymphoblastic Leukemia Using an Eight-Color Tube with Dried Anti- body Reagents. Cytometry Part B 2019; 96B: 158–163. Minimal residual disease (MRD) assessment repre- introduction of specific newly described markers signif- sents a predictive and independent risk factor and a icantly improved FCM-MRD analysis in BCP-ALL (5–8). useful tool in the clinical management of B-cell precur- Among the advantages of the FCM, the possibility to sor (BCP) acute lymphoblastic leukemia (ALL) (1,2). have results just a few hours after sample collection is Two methods coexist for studying MRD: Multipara- highly appreciated by clinicians, especially for patients metric Flow Cytometric (MFC) analysis of leukemia- who need a specific care. associated immunophenotypes (LAIP) and polymerase fi chain reaction (PCR) ampli cation of antigen receptor *Correspondence to: Dr Marie Loosveld, 264 rue Saint Pierre, 13005 rearrangements (3). Garand et al. have demonstrated in Marseille, France. Email: [email protected] a multicenter study that PCR and MFC are highly com- Received 8 June 2018; Revised 13 December 2018; Accepted 9 plementary strategies for MRD detection in ALL (4) and January 2019 Published online 30 January 2019 in Wiley Online Library several studies have shown that the use of multicolor (wileyonlinelibrary.com). (>6 markers) immunostainings combined with the DOI: 10.1002/cyto.b.21766 © 2019 International Clinical Cytometry Society B-ALL MRD ASSESSMENT WITH MULTICOLOR DRY TUBE 159 Nevertheless, the workflow in clinical flow cytometry and BM samples were diluted in order to obtain 106 laboratories must constantly be reviewed to develop cells in 100 μl. Secondly, cells were incubated in the technical procedures that improve quality and produc- dark at room temperature for 15 min with the antibody tivity, and reduce costs. Indeed, clinical flow cytometry cocktail. On the other hand, CSF samples were directly laboratories face discrepancies due to pipetting errors, incubated with the cocktail without lysing and washing short shelf life of products, planification of cocktail steps. reagents, lot to lot potential variation, and some lack of The liquid reagent tube was tested in parallel and standardization. considered as the reference. This tube included seven Classically (and it is the case for our laboratory), a fluorochrome-conjugated liquid antibodies with combination of 8 to 10-color tubes is used to analyze CD45Krome Orange (J.33), CD10FITC (ALB1), CD34 MRD at different time points (peripheral blood or bone ECD (581), CD58PC5 (AICD58), CD19PC7 (J3-119), marrow MRD analysis). In this context, Beckman CD38APC (HB-7), CD20 AA750 (B9.E9 [HRC20]). ® ® Coulter recently introduced a range of dried reagents The Duraclone tube included seven Beckman Coulter with a specific tube for the detection of B Acute Lym- fluorochrome-conjugated dried antibodies: CD45Krome ® phoblastic Leukemia MRD called “Duraclone Rare Orange (J.33), CD58FITC (AICD58), CD34ECD (581), Events ALB” (RE-ALB). CD10PC5.5 (ALB1), CD19PC7 (J3-119), CD38 AA700 The aim of this study is to evaluate the applicability (LS198-4-3), CD20 AA750 (B9.E9 [HRC20]). of the RE-ALB tube in routine laboratory and test per- FL2 channel was used to add a blast-specific marker formances of this dried format reagent when compared (LAIP) antibody conjugated with PE, which was the to the currently used liquid format reagent cocktail same for liquid or dried reagent experiments. As a (control tube). result, each tube contained eight antibodies. Data were immediately acquired. MATERIALS AND METHODS Flow Cytometer and Quality Control ® Patients and Samples The instrument used was a Navios (Beckman Coulter , Twenty-two children (15 girls and 6 boys) with a de Miami, FL). Daily controls were run, including Flow novo diagnosis of B-lineage ALL were considered for Check and Flow Set Pro Fluorospheres™ (Beckman enrollment. Informed consent was obtained from par- Coulter) to monitor the instrument performance and ents/guardians and study protocols were approved by Immuno-Trol™ CellsaspartoftheelectronicInterna- the ethics committee of Marseille University Hospital. tional Quality Assurance Program (www.beckmancoulter. Samples from these patients were analyzed by morpho- com). As the fluorochromes differed between the two test logical examination and flow cytometry in our tubes, different settings and a different compensation ® laboratory. matrix were used for the Duraclone tube. Overall, 31 samples from B ALL patients were ana- Compensations were made using dried-antibody lyzed: 19 bone marrow (BM) aspirations, 10 peripheral coated single color tubes of the Compensation Kit pro- blood (PB) samples and 2 cerebrospinal fluids (CSF) at vided for Duraclone tests, according to manufacturer’s different stages of the follow-up: during the corticother- instructions. apy (n = 11), at the end of induction (MRD1; n = 8), at n the end of consolidation (MRD2; = 6), at relapse Analysis Data (n = 3), and at other time points (OTP; n = 3). In addi- fl tion, five bone marrow samples were diluted into a Analysis of ow cytometry results was made using non-pathological bone marrow. Finally, samples from Kaluza software (Beckman Coulter). As usually in FCM- patients with cytopenia but without any malignant cells MRD analysis, we did not analyze MFIs of each isolated were used as control samples. These control subjects marker but studied correlation between the two stain- ’ matched on age with pediatric patients. ing methods on the obtained MRD quantitation s. Three Patients and samples characteristics are summarized observers analyzed each MRD positive and negative fi in Table 1. case. Results were con rmed by double blinded analyses. Sample Preparation Of note, because several tandem dye
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