title: Proposed minimal panel of antibodies for cost-effectiveness and accuracy in acute leukemias immunophenotyping: Prospective study at a tertiary care center.
abstract: BACKGROUND
  Flowcytometry has an essential role in the diagnosis and classification of acute leukemias. However, there exists a great degree of inter-laboratory variability on issues like panel selection, antibody combinations, gating strategies, fluorochromes, and clonal selection.
  
  
  OBJECTIVE
  The primary aim of this study was to derive a minimal panel of antibodies and evaluate its diagnostic usefulness in acute leukemias by flowcytometry by using the detailed immune-phenotype of different lineage-specific or non-specific markers.
  
  
  METHODS
  This prospective observational study involved 400 newly diagnosed cases of acute leukemias. Bone marrow aspirate samples were subjected to morphological evaluation, cytogenetics and flow cytometric immunophenotyping.
  
  
  RESULTS
  A minimal panel of eight antibodies comprising of CD45/CD34/CD19/MPO/cytoCD3/CD64/CD117/CD79a was derived by applying different permutations and combinations with a diagnostic yield of 97.5%. The minimal panel was further validated by testing in an independent cohort of patients with similar demographic characteristics, where it showed a high diagnostic yield of 98% in comparison with the screening panels proposed by other recently published studies.
  
  
  CONCLUSIONS
  It may be concluded that the diagnostic performance of the eight antibody panel is better than most other panels used across the different laboratories in terms of yield, number of antibodies used and the scientific approach used to derive and validate the results and so henceforth may be applied in any setting with limited resources for better diagnostic accuracy.
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Neha
authors.initials: N
authors.lastname: Singh
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Hara Prasad P
authors.initials: HP
authors.lastname: Pati
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Seema
authors.initials: S
authors.lastname: Tyagi
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Roopam
authors.initials: R
authors.lastname: Deka
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Sharma
authors.affiliation: a Department of Hematology , All India Institute of Medical Sciences , New Delhi 110029 , India.
authors.forename: Renu
authors.initials: R
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007938:Leukemia / Q000188:drug therapy* / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000906:Antibodies
keywords: Acute leukemia; Immunophenotyping