Alfaro Jeanine, Valverde Patricia, Salguero Paola, Arevalo Xiomara, Ortega Pamela, Sanchez Luisa, Antillon-Klussmann Federico, Hayden Randall T, Rodriguez Alicia, Metzger Monika L, Choi John K, Santana Victor M, Mead Paul E, Kumar Priya
Department of Pediatrics, Unidad de Oncología Pediátrica, Guatemala City, Guatemala.
Francisco Marroquin University, School of Medicine, Guatemala City, Guatemala.
Front Oncol. 2025 Sep 12;15:1604295. doi: 10.3389/fonc.2025.1604295. eCollection 2025.
Despite advancements in the treatment of acute lymphoblastic leukemia (ALL), survival rates vary greatly based on factors such as cancer subtype and geographical location. The use of diagnostic tools like immunophenotyping and measurable residual disease (MRD) detection by flow cytometry (FC) are key to optimal management. FC offers higher sensitivity and rapid turnaround compared to traditional methods like morphological evaluation and immunohistochemistry. However, in low- and middle-income countries (LMIC), the adoption of robust MRD assays via FC remains limited due to challenges such as technical complexity, the need for operator expertise, and the high costs associated with antibodies and quality control. This study discusses the design, implementation, and validation of MRD strategies using FC in resource-constrained environments, highlighting the potential for improved accessibility and patient outcomes when these barriers are addressed.
尽管急性淋巴细胞白血病(ALL)的治疗取得了进展,但生存率因癌症亚型和地理位置等因素而有很大差异。使用免疫表型分析和流式细胞术(FC)检测可测量残留病(MRD)等诊断工具是优化管理的关键。与形态学评估和免疫组织化学等传统方法相比,FC具有更高的灵敏度和更快的周转速度。然而,在低收入和中等收入国家(LMIC),由于技术复杂性、对操作人员专业知识的需求以及与抗体和质量控制相关的高成本等挑战,通过FC采用强大的MRD检测方法仍然有限。本研究讨论了在资源有限的环境中使用FC的MRD策略的设计、实施和验证,强调了解决这些障碍时改善可及性和患者预后的潜力。