CLL - Residual Disease Update

on Friday, 11 January 2019. Posted in Homepage, Haematology

Website update for CLL MRD

Minimal residual disease for CLL is performed by flow cytometry within the Cell Markers Lab in Haematology. The procedure for measurement has been reviewed and updated in line with current recommendations1. The new panel provides clearer delineation of CLL populations and is able to exclude other minor B cell populations such as haematogones and plasma cells.

Sample requirements remain the same: either 1-2mls of Bone marrow or 4-5 mls PB in EDTA (although additional sample may be advisable in patients who are leucopenic).

Samples should be received and tested within 48 hours to ensure meaningful results (note that the laboratory is not open at weekends).

Reporting of CLL MRD has also been updated to provide additional information and will include:

A summary statement

A quantitation (%)                       ONLY if the level is at or above the limit of quantitation

Limit of detection (LOD)         The percentage above which CLL cells can be recognised but there are                                                                        too few to be reliably quantified.

Limit of quantitation (LOQ)    The minimum percentage at which CLL cells may be quantified.

LOD and LOQ are calculated for each patient sample.

The procedure has been optimised to achieve an LOD of 0.004% and an LOQ of 0.01%, but this is dependent upon the cellularity of the sample and may therefore be higher (and thus less sensitive).

1A complementary role of multiparameter flow cytometry and high-throughput sequencing for minimal residual disease detection in chronic lymphocytic leukaemia: a European Research Initiative on CLL study.

Rawstron et al

Leukaemia2016 Apr;30(4):929-36. doi: 10.1038/leu.2015.313. Epub 2015 Dec 7

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