A simplified minimal residual disease polymerase chain reaction method at early treatment points can stratify children with acute lymphoblastic leukemia into good and poor outcome groups.

BACKGROUND: Minimal residual disease is an important independent prognostic factor in childhood acute lymphoblastic leukemia. The classical detection methods such as multiparameter flow cytometry and real-time quantitative polymerase chain reaction analysis are expensive, time-consuming and complex, and require considerable technical expertise. DESIGN AND METHODS: We analyzed 229 consecutive children with acute lymphoblastic leukemia treated according to the GBTLI-99 protocol at three different Brazilian centers. Minimal residual disease was analyzed in bone marrow samples at diagnosis and on days 14 and 28 by conventional homo/heteroduplex polymerase chain reaction using a simplified approach with consensus primers for IG and TCR gene rearrangements. RESULTS: At least one marker was detected by polymerase chain reaction in 96.4% of the patients. By combining the minimal residual disease results obtained on days 14 and 28, three different prognostic groups were identified: minimal residual disease negative on days 14 and 28, positive on day 14/negative on day 28, and positive on both. Five-year event-free survival rates were 85%, 75.6%, and 27.8%, respectively (p<0.0001). The same pattern of stratification held true for the group of intensively treated children. When analyzed in other subgroups of patients such as those at standard and high risk at diagnosis, those with positive B-derived CD10, patients positive for the TEL/AML1 transcript, and patients in morphological remission on a day 28 marrow, the event-free survival rate was found to be significantly lower in patients with positive minimal residual disease on day 28. Multivariate analysis demonstrated that the detection of minimal residual disease on day 28 is the most significant prognostic factor. CONCLUSIONS: This simplified strategy for detection of minimal residual disease was feasible, reproducible, cheaper and simpler when compared with other methods, and allowed powerful discrimination between children with acute lymphoblastic leukemia with a good and poor outcome.

Establecimiento de intervalos de referencia en subpoblaciones linfocitarias por citometría de flujo / Reference values in lymphocyte subpopulations using flow cytometry

La determinación de Subpoblaciones Linfocitarias Humanas (SLH) por Citometría de Flujo, Linfocitos CD3+ (LT), LTCD4+, LTCD8+ y la relación LTCD4+/LTCD8+, permiten monitorear pacientes infectados con virus de la inmunodeficiencia humana (VIH), los cuales son comparados con Valores de Referencia (VR). A su vez los VR informados por la bibliografía son variables debido a la falta de validación analítica y partición estadística de los datos de VR, entre otros. En este trabajo, utilizando un ensayo validado (ISO15189), se establecieron VR para SLH con criterios estadísticos de partición en individuos con serología negativa para VIH (397 mujeres (F) y 279 varones (M), edad: 17-83 años). Las SLH fueron medidas en un Citómetro de Flujo (Coulter Epics XL-MCL). Los datos fueron procesados empleando como criterio estadístico de partición el algoritmo de Martin Gellerstedt (AMG). Del análisis estadístico y del AMG se determinó la partición de los datos en 6 subpoblaciones definidas por edad (intervalo de años) y género (F y M): grupos I y IV: 17-35 (F y M); grupos II y V: 36-50 (F y M); y grupos III y VI: >50 años (F y M). Para los 6 grupos se definieron VR de linfocitos totales, LT, LTCD4+, LTCD8+ y LTCD4+/LTCD8+. Para cada límite inferior y superior de VR se estableció el intervalo de confianza al 90%. En conclusión, este estudio permitió establecer VR para SLH en un ensayo validado empleando un criterio estadístico de partición, lo cual permitiría incrementar la confiabilidad de los resultados y uniformar a nivel internacional los VR en SLH en diferentes poblaciones.

The determination of Human Lymphocyte Subpopulations (HLS) including Lymphocytes CD3+ (LT), LTCD4+, LTCD8+ and LTCD4+/LTCD8+ ratio by flow cytometry, makes it possible to monitor patients infected who HIV, which are compared against reference values (RV). However, RV reported by the international bibliography are variable due to the absence of two main factors: analytical validation procedures and partitioning statistical criteria. This study, using a validated method (ISO15189), RV were established for HLS in individuals with negative serology for HIV (397 females (F) and 279 males (M), age: 17-83 years) applying partitioning statistical criteria. The values of HLS were obtained by flow cytometry (Coulter Epics XL-MCL). The data were processed using partitioning statistical criteria based on Martin Gellerstedt's algorithm (MGA). From the statistical analysis and MGA the partition of the data was determined in 6 subpopulations defined by age (interval of years) and gender (F and M): groups I and IV: 17-35 (F and M); groups II and V: 36-50 (F and M); and groups III and VI: >50 years (F and M). Hence, RV of total lymphocytes, LT, LTCD4+, LTCD8+ and LTCD4+/LTCD8+ ratio were defined. For each limit (lower and upper) of reference values, the 90% confidence interval was determined. In conclusion, this study allowed establishing RV for HLS in a validated method using a partitioning statistical criterion, which would allow increasing the assurance results and establishing an international criterion for reference values in HLS in different populations.

A new automated flow cytometry data analysis approach for the diagnostic screening of neoplastic B-cell disorders in peripheral blood samples with absolute lymphocytosis.

Currently, multiparameter flow cytometry immunophenotyping is the selected method for the differential diagnostic screening between reactive lymphocytosis and neoplastic B-cell chronic lymphoproliferative disorders (B-CLPD). Despite this, current multiparameter flow cytometry data analysis approaches still remain subjective due to the need of experienced personnel for both data analysis and interpretation of the results. In this study, we describe and validate a new automated method based on vector quantization algorithms to analyze multiparameter flow cytometry immunophenotyping data in a series of 307 peripheral blood (PB) samples. Our results show that the automated method of analysis proposed compares well with currently used manual approach and significantly improves semiautomated approaches and, that by using it, a highly efficient discrimination with 100% specificity and 100% sensitivity can be made between normal/reactive PB samples and cases with B-CLPD based on the total B-cell number and/or the sIgkappa+/sIglambda+ B-cell ratio. In addition, the method proved to be able to detect the presence of pathologic neoplastic B-cells even when these are present at low frequencies (<5% of all lymphocytes in the sample) and in poor-quality samples enriched in 'noise' events.

Primera experiencia en aislamiento de celulas endoteliales humans en Bolivia / First experience in the isolation of human endothelian cells in Bolivia

INTRODUCCIÓN: las células endoteliales pueden proveer información valiosa con respecto a muchos procesos patológicos como la aterosclerosis, inflamación, neoplasia y angiogénesis. Este trabajo describe la primera experiencia boliviana en el aislamiento y cultivo de células endoteliales humanas derivadas de la vena umbilical (HUVEC). MÉTODOS: Un segmento largo de cordón umbilical se utilizó para el aislamiento y fue tratado por digestión con colagenasa. Las células endoteliales fueron desprendidas de la íntima y posteriormente cultivadas en medio de cultivo M199 y suero fetal bovino. Técnicas morfológicas, inmunohistoquímicas y de citometría de flujo fueron utilizadas para identificar estas células. RESULTADOS: Se examinaron las células endoteliales obtenidas por análisis morfológico e inmunohistoquímico. El marcaje con CD34 fue positivo para más del 90% de las células obtenidas por digestión con colagenasa analizado por citometría de flujo. CONCLUSIÓN Se logró aislar y cultivar HUVEC de manera exitosa. Una gran variedad de experimentos y aplicaciones en ciencias biomédicas pueden ser potencialmente factibles.

INTRODUCTION: endothelial cell study yields valuable information concerning many pathologic processes such as atherosclerosis, inflammation, neoplasia and angiogenesis. This paper describes the first Bolivian experience in isolation and culture of human umbilical vein endothelial cells (HUVEC). METHODS: a long segment of the umbilical cord was processed by collagenase digestion. Endothelial cells were detached from intima and further cultured using M199 culture media. Morphologic, immunochemistry and flow cytometry approaches were used to identify these cells. RESULTS: morphologic and immunochemistry analysis of the pool of obtained cells were positive for HUVEC. CD34 staining was positive in more than 90% of the cells obtained by collagenase digestion as assessed by flow cytometry. CONCLUSION: HUVEC were successfully isolated for the first time in Bolivia. A great deal of further experiments and applications in biomedical sciences is possible

Statistical analysis of nuclear genome size of plants with flow cytometer data.

BACKGROUND: There is a mismatch between the sophistication of the cytometer and the resulting data, made possible by the computing power of today, and the traditional statistical methods based on the computing power of the early 1930s. The purpose here is to apply modern statistical techniques that similarly take advantage of this computer power. METHODS: Likelihood functions and their graphs are introduced as direct measures of plausibility of the parameters of interest. These methods are valid for samples of any size. They are exemplified on an experimental plant flow cytometer data set with n = 2 replications. RESULTS: The likelihood functions revealed important features of the data that would have been missed by the traditional methods, and in fact would invalidate them. CONCLUSIONS: The likelihood function produced highly informative graphs that allow quantitative comparisons of different aspects of 2C DNA nuclear contents among different groups or varieties of plants.

Citometría de flujo: una herramienta en el laboratorio inmunohematológico / Flow citofluorometry: a tooc in the immunohematological laboratory

Aplication of flow cytofluorometry to blood transfusion: flow citofluorometry has been applied to transfusion medicine for nearly twenty years now. Many of these applications have been for purposes, but several have been suggested for more routine uses. In this summary it is expected to reach of aplication the description of more intervention in the transfusion medicine: detection and quantitation of protein bound to blood cells; detection and quantitation of minor cell population; detection and quantitation of cellular antigens; detection of platelet and WBC antibodies; demostration of platelet activation; demos-tration and quantitation of mocyte interaction with IgG-sensitized RBCs (AU)

Flow cytometric quantitation of phagocytosis in heparinized complete blood with latex particles and Candida albicans

Se da cuenta de un método rápido para la cuantización del flujo citométrico de la fagocitosis en sangre periférica completamente heparinizada (HCPB), mediante la utilización de partículas de látex phycoerythrin-conjugadas de 1µm de diámetro disponibles comercialmente. El método es más rápido y presenta mayor reproducibilidad que la técnica estandar de Bjerknes' (1984) utilizando propidium iodide-teñida Candida albicans, aplicada convencionalmente a la capa leucocitica de sangre periférica pero modificada por HCPB. Tambien damos cuenta de una modificación de Bjerknes' Intracellular Killing Test para permitir su aplicación a HCPB.

We report a rapid method for the flow cytometric quantitation of phagocytosis in heparinized complete peripheral blood (HCPB), using commercially available phycoerythrin-conjugated latex particles of 1 micron diameter. The method is faster and shows greater reproducibility than Bjerknes' (1984) standard technique using propidium iodide-stained Candida albicans, conventionally applied to the leukocytic layer of peripheral blood but here modified for HCPB. We also report a modification of Bjerknes' Intracellular Killing Test to allow its application to HCPB.

Flow cytometric quantitation of phagocytosis in heparinized complete blood with latex particles and Candida albicans.

We report a rapid method for the flow cytometric quantitation of phagocytosis in heparinized complete peripheral blood (HCPB), using commercially available phycoerythrin-conjugated latex particles of 1 micron diameter. The method is faster and shows greater reproducibility than Bjerknes' (1984) standard technique using propidium iodide-stained Candida albicans, conventionally applied to the leukocytic layer of peripheral blood but here modified for HCPB. We also report a modification of Bjerknes' Intracellular Killing Test to allow its application to HCPB.

Aumento de CD4 en monocitos de pacientes con Hemofilia VIH positivos / Increased CD4 in monocytes from HIV+ Hemophilia patients

El sistema monocito macrofágico (M/M) juega un papel central en la infección por el virus de la inmunodeficiencia humana (VIH) y la expresión del antígeno CD4 sobre la superficie del M/M es un factor clave para la entrada del VIH a células susceptibles. En este trabajo evaluamos los niveles del receptor CD4 en monocitos de pacientes con hemofilia (He) infectados o no con el VIH (He-VIH+). Se estudiaron treinta pacientes He-VIH+, cuatro pacientes seronegativos (He-VIH-) y veinte dadores normales voluntarios. La evaluación fenotípica de los monocitos fue realizada por citometría de flujo a partir de sangre periférica teñida con anticuerpos monoclonales anti CD45, CD3, CD4 y CD14. Se encontró que el porcentaje de monocitos CD4+ estaba incrementado en todos los grupos de pacientes (incluyendo He-VIH-), pero fue más alto en pacientes sintomáticos He-VIH+. Además el valor más frecuente de intensidad de fluorescencia para CD4 de la población de monocitos de estos pacientes, estaba desplazado hacia zonas de mayor intensidad respecto de los individuos normales. Esto indicaría una expresión incrementada del número de moléculas CD4 sobre la membrana celular de los monocitos. Las características de esta células en los pacientes He-VIH+, podrían favorecer la persistencia y la diseminación viral.(AU)

[The immunological phenotyping of the lymphocytes in HIV+ patients]. / Fenotipificación inmunológica de linfocitos en pacientes VIH+.

We propose that the ratios of lymphocyte subsets: CD4+/CD8+, CD4+/CD3+, and CD8+/CD3+, graphically displayed in this order, could be an easy way of immunophenotyping and a simple form of interpretation both for clinicians and patients. A total of 187 asymptomatic HIV-positive patients, -including 83 symptomatic patients with AIDS- and a normal comparative age group of 36 patients, were studied by flow cytometry. Ratios were graphically displayed on millimetric-grid paper, and a specific point was given to each obtained ratio. The points were connected by a line. The angles formed by the lines were measured and graphically displayed over a circle. The point of reference 0 degree was located on the left side of the circle, giving the corresponding 90 degrees, 180 degrees, and 240 degrees angles. The graph of the control group shows a "beach chair" image. As soon as the CD4+ lymphocytes diminish and the CD8+ lymphocytes increase in HIV+ patients, "the chair's headrest" descends and the "chair's footpiece" swivels back. Given the ranks and fluctuations of the lymphocyte subsets, their graphic display provides a better representation of the immunological status.