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T‐lineage acute lymphoblastic leukemia (T‐ALL) accounts for about 15% of pediatric and about 25% of adult ALL cases. Minimal/measurable residual disease (MRD) assessed by flow cytometry (FCM) is an important prognostic indicator for risk stratification. In order to assess the MRD a limited number of antibodies directed against the most discriminative antigens must be selected. We propose a pipeline for evaluating the influence of different markers for cell population classification in FCM data. We use linear support vector machine, fitted to each sample individually to avoid issues with patient and laboratory variations. The best separating hyperplane direction as well as the influence of omitting specific markers is considered. Ninety‐one bone marrow samples of 43 pediatric T‐ALL patients from five reference laboratories were analyzed by FCM regarding marker importance for blast cell identification using combinations of eight different markers. For all laboratories, CD48 and CD99 were among the top three markers with strongest contribution to the optimal hyperplane, measured by median separating hyperplane coefficient size for all samples per center and time point (diagnosis, Day 15, Day 33). Based on the available limited set tested (CD3, CD4, CD5, CD7, CD8, CD45, CD48, CD99), our findings prove that CD48 and CD99 are useful markers for MRD monitoring in T‐ALL. The proposed pipeline can be applied for evaluation of other marker combinations in the future. [ABSTRACT FROM AUTHOR]

Minimal residual disease (MRD) as measured by multiparameter flow cytometry (FCM) is an independent and strong prognostic factor in B‐cell acute lymphoblastic leukemia (B‐ALL). However, reliable flow cytometric detection of MRD strongly depends on operator skills and expert knowledge. Hence, an objective, automated tool for reliable FCM‐MRD quantification, able to overcome the technical diversity and analytical subjectivity, would be most helpful. We developed a supervised machine learning approach using a combination of multiple Gaussian Mixture Models (GMM) as a parametric density model. The approach was used for finding the weights of a linear combination of multiple GMMs to represent new, "unseen" samples by an interpolation of stored samples. The experimental data set contained FCM‐MRD data of 337 bone marrow samples collected at day 15 of induction therapy in three different laboratories from pediatric patients with B‐ALL for which accurate, expert‐set gates existed. We compared MRD quantification by our proposed GMM approach to operator assessments, its performance on data from different laboratories, as well as to other state‐of‐the‐art automated read‐out methods. Our proposed GMM‐combination approach proved superior over support vector machines, deep neural networks, and a single GMM approach in terms of precision and average F1‐scores. A high correlation of expert operator‐based and automated MRD assessment was achieved with reliable automated MRD quantification (F1‐scores >0.5 in more than 95% of samples) in the clinically relevant range. Although best performance was found, if test and training samples were from the same system (i.e., flow cytometer and staining panel; lowest median F1‐score 0.92), cross‐system performance remained high with a median F1‐score above 0.85 in all settings. In conclusion, our proposed automated approach could potentially be used to assess FCM‐MRD in B‐ALL in an objective and standardized manner across different laboratories. © 2019 International Society for Advancement of Cytometry [ABSTRACT FROM AUTHOR]