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Peripheral blood 8 colour flow cytometry monitoring of hairy cell leukaemia allows detection of high‐risk patients
Author(s) -
Garnache Ottou Francine,
Chandesris MarieOlivia,
Lhermitte Ludovic,
Callens Céline,
Beldjord Kheira,
Garrido Marlene,
Bedin AnneSophie,
Brouzes Chantal,
Villemant Sarah,
Rubio MarieThérèse,
Belanger Coralie,
Suarez Felipe,
Deau Bénédicte,
Lefrère François,
Hermine Olivier,
Asnafi Vahid,
Varet Bruno,
Macintyre Elizabeth
Publication year - 2014
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12839
Subject(s) - flow cytometry , minimal residual disease , medicine , biomarker , gastroenterology , hematology , polymerase chain reaction , b cell , immunology , bone marrow , biology , antibody , biochemistry , gene
Summary Although purine analogues have significantly improved the outcome of hairy cell leukaemia ( HCL ) patients, 30–40% relapse, illustrating the need for minimal residual disease ( MRD ) markers that can aid personalized therapeutic management. Diagnostic samples from 34 HCL patients were used to design an 8‐colour flow cytometry (8‐ FC ) tube for blood MRD (B/ RD ) analysis (188 samples) which was compared to quantitative IGH polymerase chain reaction (Q‐ PCR ) on 83 samples and to qualitative consensus IGH PCR clonality analysis on 165 samples. Despite heterogeneous HCL phenotypes at diagnosis, discrimination from normal B lymphocytes was possible in all cases using a single 8‐ FC tube, with a robust sensitivity of detection of 10 −4 , comparable to Q‐ PCR at this level, but preferable in terms of informativeness, simplicity and cost. B/ RD assessment of 15 patients achieving haematological complete remission after purine analogues was predictive of a clinically significant relapse risk: with a median follow‐up of 95 months; only one of the nine patients with reproducible 8‐ FC B/ RD levels below 10 −4 (B/ RD neg ) relapsed, compared to 5/6 in the B/ RD pos group ( P = 0·003). These data demonstrate the clinical interest of a robust 8‐ FC HCL B/ RD strategy that could become a surrogate biomarker for therapeutic stratification and new drug assessment, which should be evaluated prospectively.