Minimal disease detection and confirmation in hematologic malignancies: combining cell sorting with clonality profiling.

Abstract:

BACKGROUND:In this study we demonstrate the technical application of flow cytometry and cell sorting combined with gene-rearrangement clonality profiling to detect and confirm minimal disease in 2 leukemia and 2 lymphoma cases. METHODS:Specimens with low percentages (0.05%-5%) of abnormal lymphoid populations were identified by flow cytometry. The abnormal lymphoid populations were sorted by flow cytometry, and the purified tumor populations along with unsorted fractions were subsequently analyzed for the presence of clonal gene rearrangements by PCR and fluorescence-based capillary electrophoresis fragment analysis. RESULTS:In 3 cases, distinct clonality profiles could be detected in the purified tumor cell fraction, and suspicious amplicons of identical sizes were detected among the polyclonal backgrounds in the unsorted specimens. For 1 patient, a monoclonal signal was detected in the sorted tumor cell fraction but not in the unseparated bone marrow specimen containing 0.05% abnormal lymphoblasts. A subsequent bone marrow specimen containing 4.8% recurring leukemia cells tested positive with a clonality profile that matched the previous profile in the sorted cell population. CONCLUSIONS:The described method integrating 2 technologies allows genotypic confirmation of an aberrant population detected by immunophenotype to increase diagnostic certainty. This strategy provides a sensitive tool for disease monitoring without the need for patient-specific primer design and assay optimization required for quantitative PCR analysis.

journal_name

Clin Chem

journal_title

Clinical chemistry

authors

Zehentner BK,Fritschle W,Stelzer T,Ghirardelli KM,Hunter K,Wentzel C,Bennington R,Hansen CL,Myerson D,Kalnoski M,Wells DA,Loken MR

doi

10.1373/clinchem.2005.061259

subject

Has Abstract

pub_date

2006-03-01 00:00:00

pages

430-7

issue

3

eissn

0009-9147

issn

1530-8561

pii

clinchem.2005.061259

journal_volume

52

pub_type

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