1
|
Raskovalova T, Scheffen L, Jacob MC, Chevalier S, Tondeur S, Bulabois B, Meunier M, Szymanski G, Lefebvre C, Planta C, Dumestre-Perard C, Gonnet N, Garban F, Merle R, Park S, Labarère J. Flow cytometry lyophilised-reagent tube for quantifying peripheral blood neutrophil myeloperoxidase expression in myelodysplastic syndromes (MPO-MDS-Develop): protocol for a diagnostic accuracy study. BMJ Open 2022; 12:e065850. [PMID: 36207039 PMCID: PMC9557768 DOI: 10.1136/bmjopen-2022-065850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Suspicion of myelodysplastic syndromes (MDS) is the most common reason for bone marrow aspirate in elderly patients. Peripheral blood neutrophil myeloperoxidase expression quantified by flow cytometric analysis might rule out MDS for up to 35% of patients referred for suspected disease, without requiring bone marrow aspiration. Yet laboratory-developed liquid antibody cocktails have practical limitations, because of lack of standardisation and poor stability. This research project aims to estimate the level of agreement and comparative accuracy between a single-use flow cytometry tube of lyophilised reagents (BD Lyotube Stain 468) and its laboratory-developed liquid reagent counterpart in quantifying peripheral blood neutrophil myeloperoxidase expression, among adult patients referred for suspected MDS. METHODS AND ANALYSIS The MPO-MDS-Develop project is a cross-sectional diagnostic accuracy study of two index tests by comparison with a reference standard in consecutive unselected adult patients conducted at a single university hospital. Flow cytometry analysis of peripheral blood samples will be performed by independent operators blinded to the reference diagnosis, using either Lyotube Stain 468 or laboratory-developed liquid reagent cocktail. The reference diagnosis of MDS will be established by cytomorphological evaluation of bone marrow aspirate by two independent haematopathologists blinded to the index test results. Morphologic assessment will be complemented by bone marrow flow cytometric score, karyotype and targeted next-generation sequencing panel of 43 genes, where relevant. The target sample size is 103 patients. ETHICS AND DISSEMINATION An institutional review board (Comité de Protection des Personnes Sud Est III, Lyon, France) approved the protocol prior to study initiation (reference number: 2020-028-B). Participants will be recruited using an opt-out approach. Efforts will be made to release the primary results within 6 months of study completion. TRIAL REGISTRATION NUMBER NCT04399018.
Collapse
Affiliation(s)
- Tatiana Raskovalova
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
| | - Laura Scheffen
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Marie-Christine Jacob
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
| | - Simon Chevalier
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Sylvie Tondeur
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Bénédicte Bulabois
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Mathieu Meunier
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
| | - Gautier Szymanski
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Christine Lefebvre
- Laboratoire d'Hématologie Biologique, Grenoble Alpes University Hospital, Grenoble, France
| | - Charlotte Planta
- Laboratoire d'Immunologie, Grenoble Alpes University Hospital, Grenoble, France
| | | | - Nicolas Gonnet
- CIC 1406, INSERM, Grenoble Alpes University Hospital, Univ. Grenoble Alpes, Grenoble, France
| | - Frédéric Garban
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
- TIMC, UMR 5525, CNRS, Univ. Grenoble Alpes, Grenoble, France
| | - Raymond Merle
- Département Universitaire des Patients, Univ. Grenoble Alpes, Grenoble, France
| | - Sophie Park
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Univ. Grenoble Alpes, Grenoble, France
- Clinique Universitaire d'Hématologie, Grenoble Alpes University Hospital, Grenoble, France
| | - José Labarère
- TIMC, UMR 5525, CNRS, Univ. Grenoble Alpes, Grenoble, France
- Clinical Epidemiology Unit, Grenoble Alpes University Hospital, Grenoble, France
| |
Collapse
|
2
|
Glencross DK, Swart L, Pretorius M, Lawrie D. Evaluation of fixed-panel, multicolour ClearLLab 10C at an academic flow cytometry laboratory in Johannesburg, South Africa. Afr J Lab Med 2022; 11:1458. [PMID: 35937760 PMCID: PMC9350555 DOI: 10.4102/ajlm.v11i1.1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Flow cytometric immunophenotyping is well established for the diagnosis of haematological neoplasms. New commercially available systems offer fixed, pre-aliquoted multi-parameter analysis to simplify sample preparation and standardise data analysis. Objective The Beckman Coulter (BC) ClearLLab™ 10C (4-tube) system was evaluated against an existing laboratory developed test (LDT). Methods Peripheral blood and bone marrow aspirates (n = 101), tested between August 2019 and November 2019 at an academic pathology laboratory in Johannesburg, South Africa, were analysed. Following daily instrument quality control, samples were prepared for LDT (using > 20 2–4-colour in-house panels and an extensive liquid monoclonal reagent repertoire) or ClearLLab 10C, and respectively analysed using in-house protocols on a Becton Dickinson FACSCalibur, or manufacturer-directed protocols on a BC Navios. Becton Dickinson Paint-a-Gate or BC Kaluza C software facilitated data interpretation. Diagnostic accuracy (concordance) was established by calculating sensitivity and specificity outcomes. Results Excellent agreement (clinical diagnostic concordance) with 100% specificity and sensitivity was established between LDT and ClearLLab 10C in 67 patients with a haematological neoplasm and 34 participants with no haematological disease. Similar acceptable diagnostic concordance (97%) was noted when comparing ClearLLab 10C to clinicopathological outcomes. Additionally, the ClearLLab 10C panels, analysed with Kaluza C software, enabled simultaneous discrimination of disease and concurrent background myeloid and lymphoid haematological populations, including assessing stages of maturation or sub-populations. Conclusion ClearLLab 10C panels provide excellent agreement to existing LDTs and may reliably be used for immunophenotyping of haematological neoplasms, simplifying and standardising sample preparation and data acquisition.
Collapse
Affiliation(s)
- Deborah K Glencross
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Leanne Swart
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Melanie Pretorius
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Molecular Medicine and Haematology, Charlotte Maxeke Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
| |
Collapse
|
3
|
Brestoff JR, Frater JL. Contemporary Challenges in Clinical Flow Cytometry: Small Samples, Big Data, Little Time. J Appl Lab Med 2022; 7:931-944. [DOI: 10.1093/jalm/jfab176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Immunophenotypic analysis of cell populations by flow cytometry has an established role in primary diagnosis and disease monitoring of many hematologic diseases. A persistent problem in evaluation of specimens is suboptimal cell counts and low cell viability, which results in an undesirable rate of analysis failure. In addition, the increased amount of data generated in flow cytometry challenges existing data analysis and reporting paradigms.
Content
We describe current and emerging technological improvements in cell analysis that allow the clinical laboratory to perform multiparameter analysis of specimens, including those with low cell counts and other quality issues. These technologies include conventional multicolor flow cytometry and new high-dimensional technologies, such as spectral flow cytometry and mass cytometry that enable detection of over 40 antigens simultaneously. The advantages and disadvantages of each approach are discussed. We also describe new innovations in flow cytometry data analysis, including artificial intelligence-aided techniques.
Summary
Improvements in analytical technology, in tandem with innovations in data analysis, data storage, and reporting mechanisms, help to optimize the quality of clinical flow cytometry. These improvements are essential because of the expanding role of flow cytometry in patient care.
Collapse
Affiliation(s)
- Jonathan R Brestoff
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - John L Frater
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
4
|
|
5
|
Hedley BD, Cheng G, Keeney M, Kern W, Padurean A, Luider J, Chin‐Yee I, Lowes LE, Rohrbach J, Ortega R, Smit A, Lo K, Magari R, Tejidor L. A multicenter study evaluation of the ClearLLab 10C panels. Cytometry B Clin Cytom 2021; 100:225-234. [PMID: 32667744 PMCID: PMC8048967 DOI: 10.1002/cyto.b.21935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/20/2020] [Accepted: 06/16/2020] [Indexed: 11/26/2022]
Abstract
Multiparameter flow cytometry plays an important role in the diagnosis, staging, and monitoring of patients with a suspected hematological malignancy. The ClearLLab 10C Panels consist of four reagent panels (B-Lineage Tube, T-Lineage Tube, and 2 Myeloid Lineage Tubes), each consisting of 10 color/10 antibody conjugates utilizing Beckman Coulters proprietary dry format optimized for investigating patients with suspected leukemia or lymphoma. A multicenter study was conducted to evaluate the performance of the ClearLLab 10C Panels for qualitative assessment of normal versus abnormal phenotype in peripheral blood, bone marrow, and lymph node samples with suspected hematological malignancies. ClearLLab 10C was compared to laboratory developed tests (LDTs) and final clinical diagnosis. Four clinical sites were used to enroll patient's spent specimens (n = 453); three laboratories in North America and one in Europe. Of the 453 specimens, 198 had no malignancy and 255 contained an abnormal population. The diagnostic accuracy of the ClearLLab 10C Panels was achieved with sensitivity of 96% and specificity of 95% with respect to patient final clinical diagnosis. The agreement of phenotyping between ClearLLab10C Panels and LDTs was 98%. Any differences noted between ClearLLab 10C and LDT were due to either the presence of populations below the level of detection, the lack of clinical information provided to the evaluators, or marker(s) not present in these panels. Overall, the ClearLLab 10C demonstrated excellent agreement to LDTs and diagnosis. These four reagent panels can be adopted by individual laboratories to assess the presence or absence of malignancy.
Collapse
Affiliation(s)
- Benjamin D. Hedley
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Guoyan Cheng
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Michael Keeney
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Wolfgang Kern
- MLL Munich Leukemia LaboratoryDepartment of ImmunophenotypingMunichGermany
| | - Adrian Padurean
- Neogenomics Laboratory, Inc.Department of Flow CytometryFort MyersFloridaUSA
| | - Joanne Luider
- Calgary Laboratory ServicesFlow Cytometry CalgaryAlbertaCanada
| | - Ian Chin‐Yee
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Lori E. Lowes
- Department of Pathology and Laboratory MedicineLondon Health Sciences CenterLondonOntarioCanada
| | - Justin Rohrbach
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Robert Ortega
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Astrid Smit
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Ka‐Wai Lo
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Robert Magari
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| | - Liliana Tejidor
- Department of Clinical Research, Beckman Coulter, Inc.MiamiFloridaUSA
| |
Collapse
|
6
|
Espasa A, Torrents S, Morales‐Indiano C, Rico LG, Bardina J, Ancochea A, Bistué‐Rovira À, Linio R, Raya M, Vergara S, Juncà J, Grifols J, Petriz J, Soria M, Sorigue M. Diagnostic performance of the ClearLLab 10C B cell tube. Cytometry 2020; 100:519-530. [DOI: 10.1002/cyto.b.21955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Andrea Espasa
- Hematology Laboratory Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Functional cytomics‐IJC, Universitat Autònoma de Barcelona Badalona Spain
| | | | - Cristian Morales‐Indiano
- Clinical Laboratory ICS‐Metropolitana Nord, Core‐Hematology Department Hospital Germans Trias i Pujol Badalona Spain
| | - Laura G. Rico
- Functional Cytomics, Josep Carreras Leukaemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona Barcelona Spain
| | - Jorge Bardina
- Functional Cytomics, Josep Carreras Leukaemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona Barcelona Spain
| | - Agueda Ancochea
- Banc de Sang i Teixits Hospital Germans Trias i Pujol Badalona Spain
| | - Àngel Bistué‐Rovira
- Functional Cytomics, Josep Carreras Leukaemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona Barcelona Spain
| | - Rosa Linio
- Banc de Sang i Teixits Hospital Germans Trias i Pujol Badalona Spain
| | - Minerva Raya
- Hematology Laboratory Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Functional cytomics‐IJC, Universitat Autònoma de Barcelona Badalona Spain
| | - Sara Vergara
- Hematology Laboratory Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Functional cytomics‐IJC, Universitat Autònoma de Barcelona Badalona Spain
| | - Jordi Juncà
- Hematology Laboratory Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Functional cytomics‐IJC, Universitat Autònoma de Barcelona Badalona Spain
- Functional Cytomics, Josep Carreras Leukaemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona Barcelona Spain
| | | | - Jordi Petriz
- Functional Cytomics, Josep Carreras Leukaemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona Barcelona Spain
| | | | - Marc Sorigue
- Hematology Laboratory Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Functional cytomics‐IJC, Universitat Autònoma de Barcelona Badalona Spain
| |
Collapse
|
7
|
Mandy F. Issue Highlights - November 2019. Cytometry B Clin Cytom 2020; 96:447-448. [PMID: 31738011 DOI: 10.1002/cyto.b.21856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/09/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022]
|
8
|
Wang SA. Issue Highlights-September 2018 (94B5). Cytometry B Clin Cytom 2019; 94:560-564. [PMID: 30240159 DOI: 10.1002/cyto.b.21740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
9
|
Affiliation(s)
- Limor Cohen
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - David R. Walt
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
| |
Collapse
|