9-color and 10-color flow cytometry in the clinical laboratory.

CONTEXT: The development of commercial flow cytometers capable of detecting more than 10 simultaneous fluorescent signals presents opportunities for improved diagnosis and monitoring of patients with leukemia and lymphoma. OBJECTIVE: To describe instrument and reagent characteristics necessary for successful 9-color and 10-color flow cytometry in a clinical setting. DESIGN: Systematic review of issues related to instrument settings, reagent performance, and general principles of panel construction. RESULTS: Nine-color and 10-color flow cytometry offers the possibility for increased accuracy in population identification, the ability to obtain detailed information from paucicellular specimens, improved laboratory efficiency, and the means to consistently detect abnormal populations at low levels. Careful attention to details of instrument and reagent performance allows for the development of panels suitable for screening of samples for leukemia and lymphoma in a clinical setting. CONCLUSIONS: The characteristics of this technique are particularly well suited to the analysis of leukemia and lymphoma and have the potential to revolutionize and standardize this type of analysis in the clinical laboratory.