Anna Porwit — Australasian Cytometry Society

Anna Porwit

Lund University, Department of Clinical Sciences, SKNE, Sweden

  • This delegate is presenting an abstract at this event.
Lund University Hospital, Sweden Since 1990 I have been conducting developmental and clinical research work in the area of diagnostic applications of flow cytometry (FCM). At the laboratory of Prof. G. Janossy, the Royal Free Hospital in London, UK, I performed some of the first published studies that applied quantitative flow cytometry in clinical material. From 1994 onwards, the studies were conducted within the BIOMED I Concerted Action: ”Investigation of Minimal Residual Disease in Acute Leukemia: International Standardization and Clinical Evaluation”. B and T cell subsets in the BM have been thoroughly characterized forming the basis for determination of aberrant phenotypes in acute lymphoblastic leukemia (ALL). Using multiparameter FCM, we could define the plot areas where no normal cells were found (sc. “empty spaces”). These characteristics allow the use of FCM to follow-up virtually all T-ALL and most of B-ALL cases. Using the described methodology, my group at the Karolinska Institute in Stockholm, Sweden, have performed own studies. In the cohort of patients treated at the Dept. of Childhood Oncology, KS, we defined using “live gate” analysis the levels of MRD >0.01% of BM cells as significant for outcome in childhood ALL. Moreover, we showed that sensitivity and specificity of FCM detection of MRD were similar to very sensitive PCR-based methodology. We have also determined the significance of MRD studies in young adults with AML and we showed application of a new marker that can be used in childhood ALL MRD studies. Between 2000 and 2010, I have organized the work of the Nordic Laboratories for immunophenotyping and minimal disease follow up of childhood leukaemia. These studies are now implemented as a part of recently started NOPHO 2008 treatment program for childhood acute lymphoblastic leukemia. A significant effort has been made to standardize the methodology between various laboratories and to compare the FCM method to molecular analysis using immunoglobulin heavy chain and T-cell receptor gene rearrangement methodology. Since 2004, I have been an active member of the European Leukemia Net Work Package 10, Diagnostics (www.leukemia-net.org/ content/ diagnostics/diagnostics/morphology/ ) aimed on standardization of morphological and flow cytometry diagnostics in leukemia and lymphoproliferative disorders. In cooperation with the ELN Work Package 8, a working Group has been created aiming on Standardization and research in application of FCM in diagnosis and prognosis of patients with myelodysplastic syndromes (MDS). Currently, in cooperation with laboratories in Germany and France, I develop a 10-color FCM analysis program for MDS. At the Flow Cytometry Laboratory, UHN, we are in process of developing the 10-color FCM program for detection of minimal residual disease in acute leukemia. I wrote parts concerning flow cytometry in several chapters concerning myeloid malignanices of the WHO 2008 fascicle. I am taking part in the Working Groups organized by International Committee for Standardization in Hematology. The first publication concerned the guidelines for bone marrow diagnostics and the current project concerns standardization of immunohistochemistry in bone marrow biopsies. Since 2006, I have been a member of the Coordinating Committee of the European Bone Marrow Working Group and Chairperson 2010-2012. I have also been actively taking part in development of quality assurance programs in FCM in Sweden (being a member of advisory group on flow cytometry for SWEDAC) and in hematopathology (member of quality assurance KVAST committee on hematopathology). In Canada, I became a member of the Hematology Committee of QMPLS in April 2012. As the reference pathologist for the Nordic MDS Group, I have been involved in several projects concerning treatment of MDS patients and more recently in the evaluation of the clinical significance of p53 mutations and aberrant p53 protein expression in MDS (current PhD project). I have also been leading and taking part in several cooperative research projects in the field of lymphoma. Studies in Hodgkin lymphoma concerned Epstein-Barr virus expression in Hodgkin´s disease in relation to patient characteristics, serum factors and blood lymphocyte function, tissue eosinophilia in relation to immunopathological and clinical characteristics of the patients, characteristics of the elderly patients with Hodgkin lymphoma, and inflammation and tissue repair marker expression in two major subtypes of Hodgkin lymphoma.