Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children73410.24287/1726-1708-2023-22-2-175-184DIAGNOSTIC GUIDELINESДИАГНОСТИЧЕСКИЕ РЕКОМЕНДАЦИИGuidelines for the flow cytometric minimal residual disease monitoring in B-lineage acute lymphoblastic leukemia after CD19-directed immunotherapyРекомендации по определению минимальной остаточной болезни методом проточной цитометрии при остром В-лимфобластном лейкозе в условиях применения CD19-направленной терапииhttps://orcid.org/0000-0002-3450-0498MikhailovaE. V.МихайловаЕ. В.
Russian Federation

Ekaterina V. Mikhailova, MD

Leukemia Immunophenotyping Laboratory

117997

1 Samory Mashela St.

Moscow

Екатерина Валерьевна Михайлова, врач клинической лабораторной диагностики

лаборатория иммунофенотипирования гемобластозов

117997

ул. Саморы Машела, 1

Москва

katmikhailova1805@gmail.comhttps://orcid.org/0000-0003-2685-674XIllarionovaO. I.ИлларионоваО. И.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-1735-0093MaschanM. A.МасчанМ. А.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-2322-5734NovichkovaG. A.НовичковаГ. А.
Russian Federation

Moscow

Москва

KarachunskiyA. I.КарачунскийА. И.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-0889-6986PopovA. M.ПоповА. М.
Russian Federation

Moscow

Москва

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России080720232221751840604202325052023Copyright ©; 2025, «D. Rogachev NMRCPHOI»Copyright ©; 2025, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2025«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/734

   Multicolor flow cytometry is now routinely used in laboratory practice for the minimal residual disease (MRD) monitoring in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Wide application of CD19-directed immunotherapy leads to frequent loss of CD19 expression, that hampers significantly the flow cytometric MRD detection methodology. We developed an antibody panel and data analysis algorithm for multicolor flow cytometry, which is a reliable method for MRD detection in patients with BCP-ALL treated with CD19-directed therapy. We recommend a single-tube 11-color panel for MRD detection, which is adapted for the case of possible CD19 loss. Based on patterns of antigen expression changes and the relative expansion of normal CD19-negative BCPs, guidelines for multicolored flow cytometry data analysis and interpretation are established. The recommended approach is reliable tool for therapy response monitoring displaying the same effectiveness with the more laborious and costly molecular techniques.

   Многоцветная проточная цитометрия широко используется в современной лабораторной практике для определения минимальной остаточной болезни (МОБ) у пациентов с острым лимфобластным лейкозом из В-клеточных предшественников (ВП-ОЛЛ). Активное внедрение в лечебную практику таргетных препаратов, приводя к частичной или полной потере CD19 на поверхности опухолевых клеток, существенно осложняет мониторинг МОБ. В данной работе представлен рекомендованный подход к поиску МОБ при ВП-ОЛЛ после таргетной  терапии. Данный подход учитывает возможную потерю основного таргетируемого антигена CD19, изменения в антигенном профиле опухоли и особенности нормальных клеточных популяций костного мозга при применении иммунотерапии. Разработанная панель антител и алгоритм анализа позволяют проводить мониторинг результатов терапии с высокой эффективностью, не уступающей значительно менее воспроизводимым и более дорогостоящим молекулярным методам.

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