Dry Run

Flow cytometry is the benchmark for delivering rapid and accurate analysis of hematologic malignancies, such as lymphoma and leukemia. However, pathology laboratories face several complications when using in-house antibody panels with wet reagents, including reagent waste, time-consuming validations, and batch-to-batch variations. Today, life science companies can offer standardized dry-antibody panels to transform flow cytometry networks. We are already starting to see the direct impact of these panels in flow cytometry laboratories; for example, at Cabell Huntington Hospital in West Virginia, where individualized cancer care is a priority.

For Jennifer McCallister, the medical technologist in the Cabell Huntington Hospital’s cancer center, working in a small setting is what fuels her passion. “The beauty of a small setting is I get to know my patients closely from collecting their bone marrow samples through preparing slides for pathology tests and tracking their outcomes and journeys,” she explains. “Also, the opportunity to discuss their results directly with expert hematopathologists has added a lot to my experience.”

McCallister has witnessed the expansion of the hospital’s flow cytometry capabilities since 2004. Initially working with four-color flow cytometers for several years, the hospital gradually upgraded to six- and eventually ten-color flow cytometers. These upgrades enabled a much more accurate population identification and the detection of low-level abnormal specimens. However, the short shelf life of wet reagents remained a significant setback. “We could validate our cocktails for only 30 days, which was often not enough to complete long-term flow cytometry experiments,” she says. “There were also times where we ran out of reagents before the month was up. Even worse – when we ended up not using the entire cocktail, we had to throw expensive reagents away.” Cabell Huntington Hospital is one of the many clinical facilities dealing with reagent waste because of antibody redundancy, reagent expiry, and reagent surplus.

Pre-optimized dry antibody panels can provide a remedy for the technical and workflow challenges, including the waste of reagents. Reagent stability is particularly important for prolonged and consistent flow cytometry assays. The transient durability of liquid reagents often requires the preparation of new batches at different time points or locations for the same assay, which inevitably leads to variation. In contrast, dry antibody panels possess long-term stability with a shelf life of 12 months at room temperature. This makes them ideal for multicentric or long-term studies, as the same panel can be repeatedly used.

The pathologists at Cabell Huntington Hospital replaced liquid reagents with dry antibody panels containing reagents for lymphoid (B-cells, T-cells) and myeloid (M1, M2) antigens. This allowed them to store antibodies at ambient temperature for 12 months. Furthermore, the duration could be extended up to 18 months for custom dry panels. An added benefit was the ease of transport at room temperature, mitigating the risk of reagent waste due to temperature excursion.

Besides durability, dry antibody panels provide various other advantages for flow cytometry workflows. For McCallister, automation was the most enticing aspect of using pre-optimized dry panels. The panel enabled a workflow where reagent pipetting, multicolor flow cytometry analysis, and data transfer could all be automated. Because the panel was quality control tested and CE and FDA approved, it could instantly be integrated into the flow cytometer without additional validation. “Time saving is the highlight of a dry panel.” McCallister says. “It eliminates the strenuous pipetting process, so I can analyze more patient samples per unit time. After running a gated analysis on our flow cytometry software, I can drop it into the pathologist’s working folder, where he can directly access it from his computer.” The result was a combination of enhanced confidence over results, streamlined data sharing, and faster turnaround for patients. 

But what about cost? At first, the benefits of dry antibody panels may seem inconspicuous; after all, their initial purchase might cost more than preparing a cocktail. However, when other important factors are considered – such as the number of clinical samples per month, the cold shipment of reagents, the frequency of cocktail preparation, and the number of control tubes required for each cocktail – the cost of using liquid reagents multiplies rapidly. On the other hand, dry antibody panels present long-term benefits by eliminating the need for cold storage and frequent cocktail preparation.

In my view, pathology laboratories should seriously consider the shift towards dry antibody panels to standardize their flow cytometry assays for rapid and accurate results. And if cost is holding you back, I urge you to plug your own numbers into our online calculator – you may be surprised by what you find.

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