Since the invention of the first flow cytometer in 1953, this laser-based technique has evolved to become an invaluable tool in basic immunology research as well as in the diagnosis and follow-up of several important diseases and medical conditions.
Having the ability to measure multiple characteristics of individual cells at a rapid rate, this technique has quickly become a cornerstone in the diagnosis and prognosis of disease and for drug therapy monitoring. Among the diseases that rely on this technology are: cancer, hematological disorders, stem cell transplantations, and HIV.
At Biolab, and consistent with our solid belief in the importance of employing cutting-edge technology and utilizing multi-parametric approaches to accurately diagnose medical conditions, extensive efforts are constantly being put to develop our flow cytometry department under the supervision of our lab director Dr. Issa Abu-Dayyeh, an immunologist with previous tumor immunology/Flow cytometry expertise at the University of Oxford, UK.
In addition to the above mentioned markers and panels, new markers and techniques are constantly being introduced. Additional markers for our leukemia panels will be introduced to make them more extensive and remain up to date. Other prognostic markers for hematological malignancies, as well as novel techniques to diagnose acquired hematological diseases are on the way.
Our department would be glad to introduce and develop new tests in coordination with physicians and specialized medical groups.
Here is a summary of the Flow Cytometry Services we currently provide:
1- Immunophenotyping Panels of Hematological Malignancies.
In close coordination with our hematopathologist Dr. Abdulrahman Al-Haliq and our cytogeneticist Mrs. Miza Hijazi, our flow cytometry department currently performs immunophenotyping panels for Acute Myeloid Leukemia (AML), Acute Lymphocytic Leukemia (ALL), and Chronic Lymphocytic Leukemia (CLL). A detailed report is issued identifying the percentage of blast cells present, in addition to their percentage expression of the relevant leukemia cell markers
2- Prognostic Markers for CLL: ZAP-70 and CD38
CLL is a heterogeneous disease with many patients not requiring treatment in their lifetimes and some that have poor prognosis. A reliable prognostic marker for CLL is ZAP-70, an intracellular molecule whose expression on B-cell blasts indicates bad prognosis (Orchard JA et al., Lancet, (2004).10;363(9403):105-11).
CD38 is another valuable prognostic marker in CLL. It has been shown that CD38+ patients are characterised by an unfavourable clinical course with a more advanced disease stage, poor responsiveness to chemotherapy, short time to initiation of first treatment, and shorter survival. In contrast, CD38- patients require minimal or no treatment, remain treatment-free for a longer time period and have prolonged survival. In fact, CD38 expression is a robust marker in the majority of patients in that it is stable over time and not significantly influenced by chemotherapy (Dürig J. et al., Leukemia, (2002). 16, 30-35).
By offering ZAP-70 and CD38 tests at Biolab, cancer patients as well as their physicians are now able to benefit from these tests to better assess the CLL case and the course of its therapy.
3- Monitoring of Rituximab treatment in cancer, autoimmune, and transplant patients.
Rituximab is sometimes used to treat a variety of diseases including cancer and autoimmune diseases. Physicians will want to assess whether the drug is binding effectively and exerting its effect on target cells. We provide the test that measures the presence/availability of the membrane protein targeted by the drug to evaluate the efficacy of its action on immune cells.
4- Evaluating CD4/CD8 counts.
A main target of the HIV virus is CD4+ T cells (T-helper cells). Therefore, it is crucial that HIV-positive patients be monitored for the percentage and absolute numbers of CD4 and CD8 cells. A fall of CD4+ numbers below a threshold level indicates that the patient has become an AIDS patient and that he is critically immunocompromised. Such data strongly affects physicians’ decisions on when and how to start antiretroviral therapy. Our department provides CD4 and CD8 percentages and absolute counts, in addition to the CD4/CD8 ratio enabling physicians to evaluate the immune status of their patients.
5- Natural Killer (NK) cells and recurrent miscarriages.
Miscarriage is one of the most common complications of pregnancy. There are many causes for recurrent miscarriages, one of which is immunological. It has been shown that some women with recurrent miscarriages have more natural killer cells in their uterine mucosa than controls and that those with the highest levels have a correspondingly high rate of miscarriage in subsequent pregnancies. We now offer NK cell percentage and absolute count in human peripheral blood and uterine tissue. However, several studies propose that it is not the number of NK cells present but rather their activity that can ultimately determine whether these cells will have a detrimental effect on pregnancies or not. To address this issue, we also provide a test where we measure the percentage and absolute numbers of activated NK cells utilizing established NK activation markers.
For further information, please contact:
Dr. Issa Abu-Dayyeh, Lab Director-Immunologist, [email protected]
Ahmad Shahin, Referral Officer, [email protected]
Jumana Abu Kwaik, Specialist technician, [email protected]
Nour Awamleh, Specialist technician, [email protected]