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Guide And Atlas For The Detection Of Minimal Residual Disease In AML

FACS Analysis and AML

Multiparameter flow cytometry measurements allow for the differential analysis of normal and abnormal cells within a peripheral blood or bone-marrow specimen. Cells are characterized by their cell size (Y axis) as well as the intensity of a cytochemical reaction for peroxidase (X axis). A second dual parameter plot defines cells on the basis of size and lobularity of the nucleus.[4] During remission, flow with the sensitivity of 10-3 can show MRD that other techniques may miss.[1]

CD7 positive AML

MRD demonstrated by flow cytometry. MRD is demonstrated by the flow cytometric detection of a very small population (1%) of CD13+/CD7+ blast cells among a predominantly mature myeloid cell population (CD13+, CD33+, and positive for mature myeloid antigens, not shown) at the time of clinical, hematological, and morphological remission. The dot plots on top reflect scatter characteristics (size and granulation) of the mononuclear cell population from this patientÝs bone marrow at the time of presentation versus remission.[4]

The myeloid nature of the blasts at presentation is demonstrated by high CD33 staining (in addition to positivity for myeloperoxidase, not shown), despite low staining for another panmyeloid antigen, CD13. The coexpression of the T-cell ˝ associated antigen, CD7, with CD13 on the myeloblasts, provides an "immunologic fingerprint" that can be followed cytometrically at the time of clinical remission.[4]

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