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<p>Minimal residual disease (MRD) assessment by multiparameter flow cytometry is an important prognostic tool in acute myeloid leukemia (AML). However, implementation in resource-constrained settings remains challenging. In this study, we evaluated the feasibility and clinical utility of a streamlined multiparameter flow cytometry approach for MRD detection in AML in a tertiary care setting. This single-centre study included 43 AML patients undergoing MRD assessment using a streamlined two-tube, eight-color flow cytometry panel incorporating leukemiaassociated immunophenotype (LAIP) and different-from-normal (DfN) strategies. MRD positivity was defined as ≥ 0.1% leukemic cells. Sensitivity approached 10⁻4 under optimal sample conditions with adequate event acquisition. Treatment regimens and clinical outcomes were recorded. MRD was negative in 24 of 43 patients at first assessment. Across all evaluated time points, the majority of samples were MRD negative. Event acquisition below optimal thresholds occurred in a subset of cases, primarily due to post-therapy marrow hypocellularity or hemodilution. MRD distribution across cytogenetic risk groups showed variability likely attributable to sample size and early attrition. Survival outcomes are presented descriptively due to limited events and short follow-up. Our results suggest that streamlined flow cytometric MRD assessment is feasible and clinically informative in real-world practice. However, larger prospective studies are required for definitive validation.</p>

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Optimizing AML MRD Detection Using a Streamlined Flow Cytometry Panel in Resource-Constrained Practice

  • 期刊论文

  • 发表日期：

    2026年4月13日

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  • Lakshita Singh,
  • Ganesh Kumar Viswanathan,
  • Jasmita Dass,
  • Mukul Aggarwal,
  • Pradeep Kumar,
  • Rishi Dhawan,
  • Tulika Seth,
  • Manoranjan Mahapatra

摘要

Minimal residual disease (MRD) assessment by multiparameter flow cytometry is an important prognostic tool in acute myeloid leukemia (AML). However, implementation in resource-constrained settings remains challenging. In this study, we evaluated the feasibility and clinical utility of a streamlined multiparameter flow cytometry approach for MRD detection in AML in a tertiary care setting. This single-centre study included 43 AML patients undergoing MRD assessment using a streamlined two-tube, eight-color flow cytometry panel incorporating leukemiaassociated immunophenotype (LAIP) and different-from-normal (DfN) strategies. MRD positivity was defined as ≥ 0.1% leukemic cells. Sensitivity approached 10⁻4 under optimal sample conditions with adequate event acquisition. Treatment regimens and clinical outcomes were recorded. MRD was negative in 24 of 43 patients at first assessment. Across all evaluated time points, the majority of samples were MRD negative. Event acquisition below optimal thresholds occurred in a subset of cases, primarily due to post-therapy marrow hypocellularity or hemodilution. MRD distribution across cytogenetic risk groups showed variability likely attributable to sample size and early attrition. Survival outcomes are presented descriptively due to limited events and short follow-up. Our results suggest that streamlined flow cytometric MRD assessment is feasible and clinically informative in real-world practice. However, larger prospective studies are required for definitive validation.