{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:37:01Z","timestamp":1790797021603,"version":"4.1.0"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Measurable residual disease (MRD) is the most relevant predictor of disease\u2010free survival in B\u2010cell acute lymphoblastic leukemia (B\u2010ALL). We aimed to establish a highly sensitive flow cytometry (MFC)\u2010based B\u2010ALL\u2010MRD (BMRD) assay for patients receiving anti\u2010CD19 immunotherapy with an alternate gating approach and to document the prevalence and immunophenotype of recurrently occurring low\u2010level mimics and confounding populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We standardized a 15\u2010color highly\u2010sensitive BMRD assay with an alternate CD19\u2010free gating approach. The study included 137 MRD samples from 43 relapsed\/refractory B\u2010ALL patients considered for anti\u2010CD19 immunotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 15\u2010color BMRD assay with CD22\/CD24\/CD81\/CD33\u2010based gating approach was routinely applicable in 137 BM samples and could achieve a sensitivity of 0.0005%. MRD was detected in 29.9% (41\/137) samples with 31.7% (13\/41) of them showing &lt;.01% MRD. Recurrently occurring low\u2010level cells that showed immunophenotypic overlap with leukemic B\u2010blasts included: (a) CD19+CD10+CD34+CD22+CD24+CD81+CD123+CD304+ plasmacytoid dendritic cells, (b) CD73bright\/CD304bright\/CD81bright mesenchymal stromal\/stem cells (CD10+) and endothelial cells (CD34+CD24+), (c) CD22dim\/CD34+\/CD38dim\/CD81dim\/CD19\u2212\/CD10\u2212\/CD24\u2212 early lymphoid progenitor\/precursor type\u20101 cells (ELP\u20101) and (d) CD22+\/CD34+\/CD10heterogeneous\/CD38moderate\/CD81moderate\/CD19\u2212\/CD24\u2212 stage\u20100 B\u2010cell precursors or ELP\u20102 cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We standardized a highly sensitive 15\u2010color BMRD assay with a non\u2010CD19\u2010based gating strategy for patients receiving anti\u2010CD19 immunotherapy. We also described the immunophenotypes of recurrently occurring low\u2010level populations that can be misinterpreted as MRD in real\u2010world practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14102","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T17:18:24Z","timestamp":1694711904000},"page":"122-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["15\u2010color highly sensitive flow cytometry assay for post <scp>anti\u2010CD19<\/scp> targeted therapy (<scp>anti\u2010CD19\u2010CAR\u2010T<\/scp> and blinatumomab) measurable residual disease assessment in B\u2010lymphoblastic leukemia\/lymphoma: Real\u2010world applicability and challenges"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-7898","authenticated-orcid":false,"given":"Gaurav","family":"Chatterjee","sequence":"first","affiliation":[{"name":"Hematopathology Laboratory, 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