A Novel System for Semiautomatic Sample Processing in Chronic Myeloid Leukaemia: Increasing Throughput without Impacting on Molecular Monitoring at Time of SARS-CoV-2 Pandemic

• Main Authors: Stefania Stella, Silvia Rita Vitale, Michele Massimino, Adriana Puma, Cristina Tomarchio, Maria Stella Pennisi, Elena Tirrò, Chiara Romano, Federica Martorana, Fabio Stagno, Francesco Di Raimondo, Livia Manzella
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Diagnostics
• Subjects: chronic myeloid leukaemia; molecular response; Q-PCR; SARS-CoV-2 infection; <i>BCR-ABL1/ABL1^IS</i>
• Online Access: https://www.mdpi.com/2075-4418/11/8/1502

Molecular testing of the <i>BCR-ABL1</i> transcript via real-time quantitative-polymerase-chain-reaction is the most sensitive approach for monitoring the response to tyrosine-kinase-inhibitors therapy in chronic myeloid leukaemia (CML) patients. Each stage of the molecular procedure has been standardized and optimized, including the total white blood cells (WBCs) and RNA isolation methods. Here, we compare the performance of our current manual protocol to a newly semiautomatic method based on the Biomek i-5 Automated Workstations integrated with the CytoFLEX Flow Cytometer, followed by the automatic QIAsymphony system to facilitate high-throughput processing samples and reduce the hands-on time and the risk associated with SARS-CoV-2. The recovery efficiency was investigated in blood samples from 100 adults with CML. We observe a 100% of concordance between the two methods, with similar total WBCs isolated (median 1.137 × 10⁶ for manual method vs. 1.076 × 10⁶ for semiautomatic system) and a comparable quality and quantity of RNA extracted (median 103 ng/μL with manual isolation kit vs. 99.95 ng/μL with the QIAsymphony system). Moreover, by stratifying patients according to their <i>BCR-ABL1</i> transcript levels, we obtained similar <i>BCR-ABL1/ABL1^IS</i> values and <i>ABL1</i> copies, and matched samples were assigned to the same group of molecular response. We conclude that this newly semiautomatic workflow has a performance comparable to our more laborious standard manual, which can be replaced, particularly when specimens from patients with suspected or confirmed SARS-CoV-2 infection need to be processed.