Applications of Flow Cytometry in The Assessment of Minimal Residual Disease in Hematologic Malignancies: A Comprehensive Review

Abstract

Background: Flow cytometry (FC) has revolutionized the diagnosis and monitoring of hematologic malignancies, particularly in the detection of minimal residual disease (MRD). The ability to identify rare leukemic cells at low levels provides critical prognostic insights that inform therapeutic strategies.

Methods: This review synthesizes recent advancements in flow cytometric techniques, including multiparametric flow cytometry (MFC) and next-generation flow cytometry (NGF), in the context of MRD assessment. The paper evaluates the integration of immunophenotypic and molecular diagnostics for the characterization of tumor clones in various hematologic disorders.

Results: Recent studies demonstrate that MFC can achieve sensitivity comparable to molecular methods, detecting MRD levels as low as 0.001%. The implementation of standardized protocols and advanced software tools enhances the reliability of MRD assessments. Notably, the identification of leukemia-associated immunophenotypes (LAIPs) and the application of the “different-from-normal” (DfN) approach significantly improve the specificity of MRD detection.

Conclusion: Flow cytometry serves as a vital tool in the monitoring of MRD in hematologic malignancies, facilitating timely therapeutic interventions and improving patient outcomes. Continued advancements in technology and methodology are essential for overcoming existing challenges and enhancing the precision of MRD evaluations across diverse clinical settings.