Skip to main content

Immunophenotyping by Multiparameter Flow Cytometry

  • Protocol
  • First Online:
Acute Myeloid Leukemia

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1633))

Abstract

Multiparameter flow cytometry has become an indispensable tool for the diagnosis and classification of acute myeloid leukemia (AML). The basic method relies on the unique ability to detect immunophenotypic abnormalities on discrete subpopulations. The primary roles in the initial assessment of AML are to determine the immaturity of the leukemic population, define the lineage and the immunophenotypic aberrancies in blasts, and identify characteristic immunophenotypic features to predict important recurrent cytogenetic and genetic abnormalities and prognosis. The established immunophenotypic profile, a baseline “fingerprint,” is used for follow-up assessment of residual disease. This chapter provides an overview of procedures for specimen processing, staining, and immunophenotyping of AML and describes our strategy for data analysis supplemented with illustrative case examples.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Protocol
USD 49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Swerdlow SH, Campo E, Harrris NL et al (eds) (2008) World Health Organization classification of tumors of haematopoietic and lymphoid tissues, 4th edn. WHO Press, Geneva, Switzerland

    Google Scholar 

  2. Craig FE, Foon KA (2008) Flow cytometric immunophenotyping for hematologic neoplasms. Blood 111:3941–3967

    Article  CAS  PubMed  Google Scholar 

  3. Kaleem Z, Crawford E, Pathan MH et al (2003) Flow cytometric analysis of acute leukemias. Diagnostic utility and critical analysis of data. Arch Pathol Lab Med 127:42–48

    PubMed  Google Scholar 

  4. Gorczyca W, Sun ZY, Cronin W et al (2011) Immunophenotypic pattern of myeloid populations by flow cytometry analysis. Methods Cell Biol 103:221–266

    Article  CAS  PubMed  Google Scholar 

  5. Khoury H, Dalal BI, Nantel SH et al (2004) Correlation between karyotype and quantitative immunophenotype in acute myelogenous leukemia with t(8;21). Mod Pathol 17:1211–1216

    Article  PubMed  Google Scholar 

  6. Kita K, Nakase K, Miwa H et al (1992) Phenotypical characteristics of acute myelocytic leukemia associated with the t(8;21)(q22;q22) chromosomal abnormality: frequent expression of immature B-cell antigen CD19 together with stem cell antigen CD34. Blood 80:470–477

    CAS  PubMed  Google Scholar 

  7. Paietta E, Goloubeva O, Neuberg D et al (2004) A surrogate marker profile for PML/RAR alpha expressing acute promyelocytic leukemia and the association of immunophenotypic markers with morphologic and molecular subtypes. Cytometry B Clin Cytom 59:1–9

    Article  CAS  PubMed  Google Scholar 

  8. Lin P, Hao S, Medeiros LJ et al (2004) Expression of CD2 in acute promyelocytic leukemia correlates with short form of PML-RARalpha transcripts and poorer prognosis. Am J Clin Pathol 121:402–407

    Article  CAS  PubMed  Google Scholar 

  9. Kern W, Voskova D, Schoch C et al (2004) Determination of relapse risk based on assessment of minimal residual disease during complete remission by multiparameter flow cytometry in unselected patients with acute myeloid leukemia. Blood 104:3078–3085

    Article  CAS  PubMed  Google Scholar 

  10. San Miguel JF, Vidriales MB, Lopez-Berges C et al (2001) Early immunophenotypical evaluation of minimal residual disease in acute myeloid leukemia identifies different patient risk groups and may contribute to postinduction treatment stratification. Blood 98:1746–1751

    Article  CAS  PubMed  Google Scholar 

  11. Campana D, Coustan-Smith E (1999) Detection of minimal residual disease in acute leukemia by flow cytometry. Cytometry 38:139–152

    Article  CAS  PubMed  Google Scholar 

  12. Borowitz MJ, Devidas M, Hunger SP et al (2008) Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's oncology group study. Blood 111:5477–5485

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Borowitz MJ, Wood BL, Devidas M et al (2015) Prognostic significance of minimal residual disease in high risk B-ALL: a report from Children’s oncology group study AALL0232. Blood 126:964–971

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Araki D, Wood BL, Othus M et al (2015) Allogeneic hematopoietic cell transplantation for acute myeloid leukemia: time to move toward a minimal residual disease-based definition of complete remission? J Clin Oncol 34:329–336

    Article  PubMed  PubMed Central  Google Scholar 

  15. Buccisano F, Maurillo L, Spagnoli A et al (2010) Cytogenetic and molecular diagnostic characterization combined to postconsolidation minimal residual disease assessment by flow cytometry improves risk stratification in adult acute myeloid leukemia. Blood 116:2295–2303

    Article  CAS  PubMed  Google Scholar 

  16. Kalina T, Flores-Montero J, van der Velden VH et al (2012) EuroFlow standardization of flow cytometer instrument settings and immunophenotyping protocols. Leukemia 26:1986–2010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Wood B (2006) 9-color and 10-color flow cytometry in the clinical laboratory. Arch Pathol Lab Med 130:680–690

    PubMed  Google Scholar 

  18. Stelzer GT, Shults KE, Loken MR (1993) CD45 gating for routine flow cytometric analysis of human bone marrow specimens. Ann N Y Acad Sci 677:265–280

    Article  CAS  PubMed  Google Scholar 

  19. Borowitz MJ, Guenther KL, Shults KE et al (1993) Immunophenotyping of acute leukemia by flow cytometric analysis. Use of CD45 and right-angle light scatter to gate on leukemic blasts in three-color analysis. Am J Clin Pathol 100:534–540

    Article  CAS  PubMed  Google Scholar 

  20. Harrington AM, Olteanu H, Kroft SH (2012) A dissection of the CD45/side scatter “blast gate”. Am J Clin Pathol 137:800–804

    Article  PubMed  Google Scholar 

  21. Xu Y, McKenna RW, Wilson KS et al (2006) Immunophenotypic identification of acute myeloid leukemia with monocytic differentiation. Leukemia 20:1321–1324

    Article  CAS  PubMed  Google Scholar 

  22. Wood BL (2003) Myeloid malignancies: myelodysplastic syndromes, myeloproliferative disorders, and acute myeloid leukemia. Clin Lab Med 27:551–575

    Article  Google Scholar 

  23. Kussick SJ, Wood BL (2003) Using 4-color flow cytometry to identify abnormal myeloid populations. Arch Pathol Lab Med 127:1140–1147

    PubMed  Google Scholar 

  24. Fuda F, Chen W (2014) Lineage determination in mixed phenotype acute leukemia: response to Marcondes et al. Cytometry B Clin Cytom 86:150–151

    Google Scholar 

  25. Al-Mawali A, Gillis D, Lewis I (2009) The role of multiparameter flow cytometry for detection of minimal residual disease in acute myeloid leukemia. Am J Clin Pathol 131:16–26

    Article  PubMed  Google Scholar 

  26. Kern W, Haferlach C, Haferlach T et al (2008) Monitoring of minimal residual disease in acute myeloid leukemia. Cancer 112:4–16

    Article  CAS  PubMed  Google Scholar 

  27. Chen W, Konoplev S, Medeiros LJ et al (2009) Cuplike nuclei (prominent nuclear invaginations) in acute myeloid leukemia are highly associated with FLT3 internal tandem duplication and NPM1 mutation. Cancer 115:5481–5489

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Kussick SJ, Stirewalt DL, Yi HS et al (2004) A distinctive nuclear morphology in acute myeloid leukemia is strongly associated with loss of HLA-DR expression and FLT3 internal tandem duplication. Leukemia 18:1591–1598

    Article  CAS  PubMed  Google Scholar 

  29. Rakheja D, Konoplev S, Medeiros LJ et al (2012) IDH mutations in acute myeloid leukemia. Hum Pathol 43:1541–1551

    Article  CAS  PubMed  Google Scholar 

  30. Yang DT, Greenwood JH, Hartung L et al (2005) Flow cytometric analysis of different CD14 epitopes can help identify immature monocytic populations. Am J Clin Pathol 124:930–936

    Article  CAS  PubMed  Google Scholar 

  31. Karandikar NJ, Aquino DB, McKenna RW et al (2001) Transient myeloproliferative disorder and acute myeloid leukemia in down syndrome. An immunophenotypic analysis. Am J Clin Pathol 116:204–210

    Article  CAS  PubMed  Google Scholar 

  32. Wang L, Peters JM, Fuda F et al (2015) Acute megakaryoblastic leukemia associated with trisomy 21 demonstrates a distinct immunophenotype. Cytometry B Clin Cytom 88:244–252

    Article  CAS  PubMed  Google Scholar 

  33. Haferlach T, Kohlmann A, Klein HU et al (2009) AML with translocation t(8;16)(p11;p13) demonstrates unique cytomorphological, cytogenetic, molecular and prognostic features. Leukemia 23:934–943

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Franklin Fuda is gratefully acknowledged for critical reading and commenting the content of this chapter. The authors also thank the medical technologists in the Clinical Flow Cytometry laboratory at the University of Texas Southwestern Medical Center for their technical assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Weina Chen M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Science+Business Media LLC

About this protocol

Cite this protocol

Chen, W., Luu, H.S. (2017). Immunophenotyping by Multiparameter Flow Cytometry. In: Fortina, P., Londin, E., Park, J., Kricka, L. (eds) Acute Myeloid Leukemia. Methods in Molecular Biology, vol 1633. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-7142-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-7142-8_4

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-7140-4

  • Online ISBN: 978-1-4939-7142-8

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics