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The role of multiparametric flow cytometry in the detection of minimal residual disease in acute leukaemia

Lee, Denise1,2; Grigoriadis, George3,4,5,6; Westerman, David1,2

Pathology - Journal of the RCPA: December 2015 - Volume 47 - Issue 7 - p 609–621
doi: 10.1097/PAT.0000000000000319

Summary: Flow cytometry is the most accessible method for minimal residual disease (MRD) detection due to its availability in most haematological centres. Using a precise combination of different antibodies, immunophenotypic detection of MRD in acute leukaemia can be performed by identifying abnormal combinations or expressions of antigens on malignant cells at diagnosis, during and post treatment. These abnormal phenotypes, referred to as leukaemia-associated immunophenotypes (LAIPs) are either absent or expressed at low frequency in normal bone marrow (BM) cells and are used to monitor the behaviour and quantitate the amount of residual disease following treatment. In paediatric acute lymphoblastic leukaemia (ALL), the level of MRD by multiparametric flow cytometry (MPFC) during therapy is recognised as an important predictor of outcome. Although less extensively studied, adult ALL and adult and paediatric acute myeloid leukaemia (AML) have also demonstrated similar findings. The challenge now is incorporating this information for risk-stratification so that therapy can be tailored individually and ultimately improve outcome while also limiting treatment-related toxicity. In this review we will elaborate on the current and future role of MPFC in MRD in acute leukaemia while also addressing its limitations.

1Peter MacCallum Cancer Centre

2University of Melbourne

3Department of Clinical Haematology, Monash and Alfred Health

4Alfred Pathology Service

5Southern Clinical School, Monash University

6Centre for Cancer Research, MIMR-PHI of Medical Research, Melbourne, Vic, Australia

Address for correspondence: Dr Denise Lee, Department of Haematopathology, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, Vic 8006, Australia. E-mail:

Received 13 November, 2014

Revised 10 August, 2015

Accepted 14 August, 2015

© 2015 Royal College of Pathologists of Australasia
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