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. 2012 Sep 5;26(9):1986–2010. doi: 10.1038/leu.2012.122

Table 9. Detailed EuroFlow Standard Operating Procedures (SOPs) for sample preparation and staining.

A. Common initial procedure when the EuroFlow antibody panel includes SmIg staining
If the EuroFlow antibody panel is going to be applied to a sample that includes SmIg staining, follow these initial steps; otherwise go directly to the backbone, surface or intracellular staining protocols (sections B, C, D, respectively):
1. Pipette 300 μl of sample into a 10-ml tube (see Note 1). Note 1: For small samples (i.e. CSF, vitreous aspirates) spin down the total volume (5 min at 540 g), discard the supernatant (see point 5) and resuspend in 300 μl of PBS+0.5% of bovine serum albumin (BSA)+0.09% sodium azide (NaN3). 2. Add 10 ml filtered PBS+0.5% BSA+0.09% NaN3 3. Mix well 4. Centrifuge for 5 min at 540 g 5. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet 6. Add 10 ml PBS+0.5% of BSA+0.09% NaN3 to the cell pellet 7. Mix well 8. Centrifuge for 5 min at 540 g 9. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet 10. Resuspend the cell pellet in 200 μl of PBS+0.5% BSA+0.09% NaN3 11. Continue with conventional EuroFlow SOPs for staining of cell surface or cell surface plus intracellular markers as described below in procedures B, C and D, respectively
 
B. Staining of backbone markers
1. Calculate the total volume of surface membrane backbone antibodies based on the number of tubes in the panel (see Note 2). Note 2: Intracellular backbone markers should not be added here. 2. Pipette these antibodies in one tube (backbone tube) 3. Calculate the total volume of sample to be stained, also based on the number of tubes in the panel and a volume of 50 μl per tube 4. Pipette this sample volume into the backbone tube 5. Mix well 6. Pipette equal amounts of the sample/backbone mix into the various tubes included in the applied EuroFlow panel (see Note 3). Note 3: Both the volume pipetted into each tube and the overall number of tubes depends on the specific EuroFlow panel that is applied. 7. Continue with the steps described below in procedure C
 
C. Staining of surface markers only (see Note 4):
Note 4: PCD tube 2 is processed identically to PCD tube 1 as described in section D if CD138-PacO is used.
1. Add the appropriate volume of antibodies directed against cell surface markers (except for the backbone markers), as recommended for each specific EuroFlow panel 2. If necessary, use PBS+0.5% BSA+0.09% NaN3 to reach a final volume of 100 μl per tube (see information on the EuroFlow panels) 3. Mix well 4. Incubate for 15 min at room temperature (RT) protected from light 5. Add 2 ml of 1x FACS Lysing Solution (10x FACS Lysing Solution diluted 1/10 vol/vol in distilled water (dH2O)) 6. Mix well 7. Incubate for 10 min at RT protected from light 8. Centrifuge for 5 min at 540 g 9. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet, leaving approximately 50 μl residual volume in each tube 10. Add 2 ml of PBS+0.5% BSA+0.09% NaN3 to the cell pellet 11. Mix well 12. Centrifuge for 5 min at 540 g 13. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet, leaving approximately 50 μl residual volume in each tube 14. Resuspend the cell pellet in 200 μl PBS+0.5% BSA+0.09% NaN3 15. Acquire the cells after staining or (if not immediately acquired) store at 4 °C maximally for 3 h until measured in the flow cytometer
 
D. Combined staining of intracellular and surface membrane markers (see Note 5):
Note 5: Tube 4 of the AML/MDS panel should be stained/processed further as described in Procedure E
1. Add the appropriate volumes of antibodies for cell surface markers, as recommended for each specific EuroFlow panel 2. If necessary, use PBS+0.5% BSA+0.09% NaN3 to reach a volume of 100 μl per tube (see information on the EuroFlow panels) 3. Mix well 4. Incubate for 15 min at RT protected from light 5. Add 2 ml of PBS+0.5% BSA+0.09% NaN3 to the cell pellet 6. Mix well 7. Centrifuge for 5 min at 540 g 8. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet, leaving approximately 50 μl residual volume in each tube 9. Resuspend the cell pellet by mixing gently 10. Add 100 μl of Reagent A (fixative; Fix&Perm, An der Grub, Vienna, Austria) 11. Incubate for 15 min at RT protected from light 12. Add 2 ml of PBS+0.5% BSA+0.09% NaN3 to the cell pellet 13. Mix well 14. Centrifuge for 5 min at 540 g 15. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet, leaving approximately 50 μl residual volume in each tube 16. Resuspend the cell pellet by mixing gently 17. Add 100 μl of Reagent B (permeabilizing solution; Fix&Perm) 18. Mix well 19. Add the appropriate volume of the intracellular antibodies (see EuroFlow panels) 20. Mix well 21. Incubate for 15 min at RT protected from light 22. Add 2 ml of PBS+0.5% BSA+0.09% NaN3 to the cell pellet 23. Mix well 24. Centrifuge for 5 min at 540 g 25. Discard the supernatant using a Pasteur pipette or vacuum system without disturbing the cell pellet, leaving approximately 50 μl residual volume in each tube 26. Resuspend the cell pellet in 200 μl PBS+0.5% BSA+0.09% NaN3 27. Acquire the cells after staining or (if not immediately acquired) store at 4 °C maximally for 3 h until measured in the flow cytometer.
 
E. Nuclear (Nu)TdT staining (Tube 4 AML/MDS EuroFlow panel):
1. Continued from procedure C step 13 2. Add the appropriate amount of the TdT antibody to the cell pellet 3. Mix well 4. Incubate for 15 min at RT protected from light 5. Add 2 ml of PBS+BSA 0.5%+0.09% NaN3 to the cell pellet 6. Mix well 7. Centrifuge for 5 min at 540 g 8. Resuspend the cell pellet in 200 μl PBS+BSA 0.5%+0.09% NaN3 9. Acquire the cells after staining or (if not immediately acquired) store at 4 °C maximally for 3 h until measured in the flow cytometer.
Overview of protocol Sections for the various EuroFlow antibody panels and corresponding tubes.
Antibody panel Tube(s) Protocol procedure
    A B C D E
ALOT 1       X  
BCP-ALL 1,4 X X X    
  2,3 X X   X  
T-ALL 1–4   X   X  
AML/MDS 1–3, 5–7   X X    
  4   X X   X
LST 1 X   X    
SST 1 X   X    
PCD 1–2   X   X  
B-CLPD 1–4 X X X    
T-CLPD 1,2,4,6   X X    
  3,5   X   X  
NK-CLPD 1,2   X X    
  3   X   X  

Abbreviations: ALOT, acute leukemia orientation tube; AML/MDS, acute myeloid leukemia and myelodysplastic syndrome; BCP-ALL, B-cell precursor acute lymphoblastic leukemia; CLPD, chronic lymphoproliferative disorder; LST, lymphoid screening tube; PCD, plasma cell disorders; SST, small sample tube; T-ALL, T-cell acute lymphoblastic leukemia.