Abstract
The quantification of submicroscopic minimal residual disease (MRD) after therapy proved to have independent prognostic significance in many mature B-cell malignancies. With the advent of routine bench-top cytometers capable of simultaneously analyzing ≥4 colors and with improved standardization, flow cytometry has become the method of choice for MRD assessments in some lymphoma entities. Herein we describe general aspects of flow cytometric standardization. Using chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) as examples we explain in detail the application of flow cytometry for MRD detection.
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References
Pott C, Schrader C, Gesk S et al (2006) Quantitative assessment of molecular remission after high-dose therapy with autologous stem cell transplantation predicts long-term remission in mantle cell lymphoma. Blood 107:2271–2278
Pott C, Hoster E, Delfau-Larue MH et al (2010) Molecular remission is an independent predictor of clinical outcome in patients with mantle cell lymphoma after combined immunochemotherapy: a European MCL intergroup study. Blood 115:3215–3223
Ladetto M, De Marco F, Benedetti F et al (2008) Prospective, multicenter randomized GITMO/IIL trial comparing intensive (R-HDS) versus conventional (CHOP-R) chemoimmunotherapy in high-risk follicular lymphoma at diagnosis: the superior disease control of R-HDS does not translate into an overall survival advantage. Blood 111:4004–4013
Lopez-Guillermo A, Cabanillas F, McLaughlin P et al (1998) The clinical significance of molecular response in indolent follicular lymphomas. Blood 91:2955–2960
Colombat P, Salles G, Brousse N et al (2001) Rituximab (anti-CD20 monoclonal antibody) as single first-line therapy for patients with follicular lymphoma with a low tumor burden: clinical and molecular evaluation. Blood 97:101–106
Rambaldi A, Lazzari M, Manzoni C et al (2002) Monitoring of minimal residual disease after CHOP and rituximab in previously untreated patients with follicular lymphoma. Blood 99:856–862
Moreton P, Kennedy B, Lucas G et al (2005) Eradication of minimal residual disease in B-cell chronic lymphocytic leukemia after alemtuzumab therapy is associated with prolonged survival. J Clin Oncol 23:2971–2979
Rawstron AC, Kennedy B, Evans PA et al (2001) Quantitation of minimal residual disease levels in chronic lymphocytic leukemia using a sensitive flow cytometric assay improves the prediction of outcome and can be used to optimize therapy. Blood 98:29–35
Moreno C, Villamor N, Colomer D et al (2006) Clinical significance of minimal residual disease, as assessed by different techniques, after stem cell transplantation for chronic lymphocytic leukemia. Blood 107:4563–4569
Lamanna N, Jurcic JG, Noy A et al (2009) Sequential therapy with fludarabine, high-dose cyclophosphamide, and rituximab in previously untreated patients with chronic lymphocytic leukemia produces high-quality responses: molecular remissions predict for durable complete responses. J Clin Oncol 27:491–497
Ysebaert L, Gross E, Kuhlein E et al (2010) Immune recovery after fludarabine-cyclophosphamide-rituximab treatment in B-chronic lymphocytic leukemia: implication for maintenance immunotherapy. Leukemia 24:1310–1316
Castro JE, James DF, Sandoval-Sus JD et al (2009) Rituximab in combination with high-dose methylprednisolone for the treatment of chronic lymphocytic leukemia. Leukemia 23:1779–1789
Maloum K, Settegrana C, Chapiro E et al (2009) IGHV gene mutational status and LPL/ADAM29 gene expression as clinical outcome predictors in CLL patients in remission following treatment with oral fludarabine plus cyclophosphamide. Ann Hematol 88:1215–1221
Bottcher S, Ritgen M, Fischer K et al (2012) Minimal residual disease quantification is an independent predictor of progression free and overall survival in chronic lymphocytic leukemia. A multivariate analysis from the randomized GCLLSG CLL8 trial. J Clin Oncol 30:980–988
Bakkus MH, Bouko Y, Samson D et al (2004) Post-transplantation tumour load in bone marrow, as assessed by quantitative ASO-PCR, is a prognostic parameter in multiple myeloma. Br J Haematol 126:665–674
Ladetto M, Pagliano G, Ferrero S et al (2010) Major tumor shrinking and persistent molecular remissions after consolidation with bortezomib, thalidomide, and dexamethasone in patients with autografted myeloma. J Clin Oncol 28:2077–2084
Paiva B, Vidriales MB, Cervero J et al (2008) Multiparameter flow cytometric remission is the most relevant prognostic factor for multiple myeloma patients who undergo autologous stem cell transplantation. Blood 112:4017–4023
Rawstron AC, Davies FE, Dasgupta R et al (2002) Flow cytometric disease monitoring in multiple myeloma: the relationship between normal and neoplastic plasma cells predicts outcome after transplantation. Blood 100:3095–3100
San Miguel JF, Almeida J, Mateo G et al (2002) Immunophenotypic evaluation of the plasma cell compartment in multiple myeloma: a tool for comparing the efficacy of different treatment strategies and predicting outcome. Blood 99:1853–1856
Dreger P, Dohner H, Ritgen M et al (2010) Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood 116:2438–2447
Ritgen M, Bottcher S, Stilgenbauer S et al (2008) Quantitative MRD monitoring identifies distinct GVL response patterns after allogeneic stem cell transplantation for chronic lymphocytic leukemia: results from the GCLLSG CLL3X trial. Leukemia 22:1377–1386
Bottcher S, Ritgen M, Pott C et al (2004) Comparative analysis of minimal residual disease detection using four-color flow cytometry, consensus IgH-PCR, and quantitative IgH PCR in CLL after allogeneic and autologous stem cell transplantation. Leukemia 18:1637–1645
Bottcher S, Ritgen M, Buske S et al (2008) Minimal residual disease detection in mantle cell lymphoma: methods and significance of four-color flow cytometry compared to consensus IGH-polymerase chain reaction at initial staging and for follow-up examinations. Haematologica 93:551–559
van der Velden VH, Cazzaniga G, Schrauder A et al (2007) Analysis of minimal residual disease by Ig/TCR gene rearrangements: guidelines for interpretation of real-time quantitative PCR data. Leukemia 21:604–611
Bottcher S, Stilgenbauer S, Busch R et al (2009) Standardized MRD flow and ASO IGH RQ-PCR for MRD quantification in CLL patients after rituximab-containing immunochemotherapy: a comparative analysis. Leukemia 23:2007–2017
Sarasquete ME, Garcia-Sanz R, Gonzalez D et al (2005) Minimal residual disease monitoring in multiple myeloma: a comparison between allelic-specific oligonucleotide real-time quantitative polymerase chain reaction and flow cytometry. Haematologica 90:1365–1372
Rawstron AC, Villamor N, Ritgen M et al (2007) International standardized approach for flow cytometric residual disease monitoring in chronic lymphocytic leukaemia. Leukemia 21:956–964
Rawstron AC, Orfao A, Beksac M et al (2008) Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders. Haematologica 93:431–438
Rawstron AC, de Tute R, Jack AS et al (2006) Flow cytometric protein expression profiling as a systematic approach for developing disease-specific assays: identification of a chronic lymphocytic leukaemia-specific assay for use in rituximab-containing regimens. Leukemia 20:2102–2110
Mateo G, Montalban MA, Vidriales MB et al (2008) Prognostic value of immunophenotyping in multiple myeloma: a study by the PETHEMA/GEM cooperative study groups on patients uniformly treated with high-dose therapy. J Clin Oncol 26:2737–2744
Kalina T, Flores J, van der Velden VH et al (2012) EuroFlow standardization of flow cytometer instrument settings and immunophenotyping protocols. Leukemia 26(9):1986–2010
Bomberger C, Singh-Jairam M, Rodey G et al (1998) Lymphoid reconstitution after autologous PBSC transplantation with FACS-sorted CD34+ hematopoietic progenitors. Blood 91:2588–2600
Acknowledgments
We are grateful to E. Harbst, L.Falck, J. Hanani, H. Hinrichs, and L. Henseleit for excellent technical support with establishing the protocols. We thank the members of the EuroFlow and ERIC consortiums for longstanding collaborations. We thank A.W. Langerak for helpful comments on the manuscript.
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Böttcher, S., Ritgen, M., Kneba, M. (2013). Flow Cytometric MRD Detection in Selected Mature B-Cell Malignancies. In: Küppers, R. (eds) Lymphoma. Methods in Molecular Biology, vol 971. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-269-8_9
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DOI: https://doi.org/10.1007/978-1-62703-269-8_9
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