Assessment of Minimal Residual Disease (MRD) by flow cytometry has become an integral component in the treatment of many haematological malignancies. These are currently the most resource intensive assays for a clinical Flow Cytometry laboratory. Furthermore, the assay techniques and analysis strategies are different from those currently used for diagnostic assays in the majority of Australasian laboratories. The implementation and maintenance of these assays has a significant impact on a clinical laboratory.
This presentation discusses practical considerations when performing MRD assays in an Australasian clinical flow cytometry laboratory. It will include assay technique, panel selection, analysis and reporting. A laboratory needs a balance between standardisation and flexibility to achieve a consistent and sustainable workflow. Standardised panels and analysis protocols are essential for identifying a neoplastic population over different time points, whether weeks or years apart. However there must be flexibility to adapt to any presentation Leukaemia Associated Immunophenotype (LAIP), and to evolving treatments that block antigen targets. Participation of clinicians in the review of results is vital to maintain confidence in the service and ensure that MRD by flow cytometry continues to contribute to patient care.