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2

Analyzing Samples for CD34 Enumeration


Using the BD™ Stem Cell Enumeration Kit

Presented by
Ellen Meinelt, MS MLS(ASCP)CM, Technical Applications Specialist and
Calin Yuan, Product Course Developer, BD Biosciences

February 29, 2012


3

Learning Objectives

• Describe the purpose of stem cell enumeration.

• Describe the purpose and uses of stem cell controls.

• List critical aspects of staining stem cell specimens.

• List the main steps in stem cell acquisition and


analysis on FACSCalibur or FACSCanto II.
4

BD Stem Cell Enumeration Kit Highlights

ISHAGE

PROCOUNT VS SCE
5

BD Stem Cell Enumeration Kit Highlights


6
Hematopoietic Stem Cells Neutrophil

 Hematopoietic stem cells can generate all lymphoid and myeloid lineages.
7

Sources & Phenotype of Hematopoietic Stem Cells

bone marrow mobilized


cord blood
peripheral blood

 Hematopoietic stem cells are CD34+ / CD45dim / SSClow / FSClow to intermediate.


8

Why Perform Stem Cell Enumeration?

 To determine when to perform bone


marrow stem cell transplants.
 To determine whether to continue
apheresis.
 To assess bone marrow and cord blood
viability.
 The viable CD34+ absolute count is a critical parameter
for rapid and sustained engraftment.
9

Let’s Review. . .

Why are stem cells enumerated?


10

BD Stem Cell Enumeration Kit Highlights

ISHAGE
History of CD34 Enumeration Protocols
1985 Siena, et al.
Milan Protocol
 Dual platform
 FSC / SSC
 50K or 50 CD34+ events
 Class III CD34 clone (1991)
History of CD34 Enumeration Protocols
1985 Siena, et al.
1994 Bender
Milan Protocol
 CD45
 Dual platform
 FSC / SSC
 50K or 50 CD34+ events
 Class III CD34 clone (1991)
History of CD34 Enumeration Protocols
1985 Siena, et al.
1994 Bender
Milan Protocol
 CD45
 Dual platform
 FSC / SSC 1995 Owens and Loken
 50K or 50 CD34+ events  7-AAD viability dye
 Class III CD34 clone (1991)
History of CD34 Enumeration Protocols
1985 Siena, et al.
1994 Bender
Milan Protocol
 CD45
 Dual platform
 FSC / SSC 1995 Owens and Loken
 50K or 50 CD34+ events  7-AAD viability dye
 Class III CD34 clone (1991) 1994, 1996 Sutherland, et al.
Original ISHAGE Protocol
 Dual platform
 4 Parameter, 2 Colors:
 FSC / SSC
 CD34 PE / CD45 FITC
 Requires isotype control
History of CD34 Enumeration Protocols
1985 Siena, et al.
1994 Bender
Milan Protocol
 CD45
 Dual platform
 FSC / SSC 1995 Owens and Loken
 50K or 50 CD34+ events  7-AAD viability dye
 Class III CD34 clone (1991) 1994, 1996 Sutherland, et al.
Original ISHAGE Protocol
 Dual platform
 4 Parameter, 2 Colors:
 FSC / SSC
 CD34 PE / CD45 FITC
 Requires isotype control

1998 BD Procount Kit


Single platform with BD™ Trucount beads
 Nucleic acid staining
 Isotype control included
 Lyse/no wash methodology
 Leukopheresis and Peripheral Blood
History of CD34 Enumeration Protocols
1985 Siena, et al.
1994 Bender
Milan Protocol
 CD45
 Dual platform
 FSC / SSC 1995 Owens and Loken
 50K or 50 CD34+ events  7-AAD viability dye
 Class III CD34 clone (1991) 1994, 1996 Sutherland, et al.
Original ISHAGE Protocol
 Dual platform
 4 Parameter, 2 Colors:
 FSC / SSC
 CD34 PE / CD45 FITC
1998 Keeney, et al.
 Requires isotype control
Modified ISHAGE Protocol
 Single platform method with 1998 BD Procount Kit
counting beads Single platform with BD™ Trucount beads
 75K or 100 CD34  Nucleic acid staining
 7-AAD viability dye  Isotype control included
 4 Parameter, 2 Colors:  Lyse/no wash methodology
 FSC / SSC  Leukopheresis and Peripheral Blood
 CD34 PE/ CD45 FITC
 Sequential gating eliminates use of
isotype control.
17

BD Stem Cell Enumeration Kit Highlights


18

Features of the BD Stem Cell Enumeration Kit

 FDA Cleared IVD test


 Meets ISHAGE guidelines
 Single tube assay
 Compatible with various
sample types and
anticoagulants
Kit contents (50 tests/kit)  Single platform with
• CD34 PE/ CD45 FITC
• 7-AAD Viability Dye
BD Trucount Tube
• NH4Cl Lysing Solution
• Trucount Tubes
19
* Dilute samples with
BD SCE Kit Sample Preparation* > 40,000 WBC/uL in
PBS with 0.5% BSA.
A FEW SIMPLE STEPS IN A SINGLE TUBE
Add 20 µL of CD45 FITC/CD34 PE reagent,
20 µL of 7-AAD, and
BD
100 µL of blood (by reverse pipetting) to a Trucount
TrucountTM
tube.
tube
Vortex and incubate in the dark at RT for 20 min.

Add 2 mL of 1X ammonium chloride lysing solution.

Vortex and incubate in the dark at RT for 10 min.

Put samples into an ice bath!

Acquire samples within 1 hour after lyse.


20

BD Stem Cell Control Kit


 BD Stem Cell Control Kit (Catalog # 340991)
 CD34 High (approximately 35 cells/L)
 CD34 Low (approximately 10 cells/L)

 Functions as
 Instrument setup and performance
 Process control for:
 antibody staining for CD34+
 7-AAD staining of non-viable cells
 red blood cell lysis

 Always run process controls prior to staining specimens.


21

Let’s Review. . .

How are stem cell controls used in the BD SCE Assay?


22

Let’s Review. . .

What are the critical aspects of


sample handling and preparation?
23

BD Stem Cell Enumeration Kit Highlights

PROCOUNT VS SCE
24
Comparison of BD SCE Kit and BD Procount Kit
BD SCE Kit BD Procount Kit
1 Meet ISHAGE Guidelines Yes No
2 No. of Tubes per Sample 1 2 (requires isotype)
3 Viability Dye 7-AAD None
4 Incubation Time 30 minutes (20 + 10) 45 minutes (15 + 30)
5 Reagent Stability 20 months 5 months
Peripheral Blood
Leukapheresis Peripheral Blood (PB)
6 Specimen Type
Bone Marrow Leukapheresis
Cord Blood
24 hours for PB
7 Specimen Stability 24 hours for all samples
6 hours for Leukapheresis
EDTA
Heparin
8 Anticoagulant EDTA
ACD-A
CPD
BD FACSCalibur
9 Cytometer (OS 9 and OS X) BD FACSCalibur OS 9 only
BD FACSCanto II
The Winner: BD SCE Kit

BD SCE KIT
26
27

BD Stem Cell Enumeration Kit Highlights


28

Analyzing samples for CD34


enumeration using BD FACSCalibur
29
Workflow overview using BD FACSCalibur
Start Up System Start up the system.

Stain the stem cell controls for instrument


Perform QC optimization and process control.
Perform cytometer QC.

Perform instrument optimization with specific


Optimize Settings
application setup (using a stem cell control).

Acquire process controls and verify results.


Acquire Data
Stain and acquire samples.

Analyze Data Analyze data and adjust gates as needed.

Shut Down System Perform daily clean and shut down system.
30

Instrument Start Up and Perform QC

Start Up Perform Optimize Acquire Analyze Shut Down


System QC Settings Data Data System

• Set up the cytometer using BD


Calibrite™ beads and BD
FACSComp™ software with
3- or 4-color lyse/no-wash assay
(Calib.LNW settings).

• Verify that all parameters pass.


Optimize Instrument Settings
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Plot 1
Use high stem cell control
(w/o 7-AAD)

• Adjust Threshold.
Plot 6

• Adjust FSC gain.


Optimize Instrument Settings
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Plot 8
Use high stem cell control
(w/o 7-AAD)

• Adjust compensation.

Plot 7
33

Acquire Data
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

• Verify settings for


acquisition and
storage.

• Add custom keywords:


Dilution Factor,
Trucount, and
Sample Volume.

• Gently vortex sample and acquire. Do not use the BD FACS TM Loader.

• Check that 100 viable CD34 events have been acquired.


34

Analyze the Acquired Data

Start Up Perform Optimize Acquire Analyze Shut Down


System QC Settings Data Data System

BD CellQuestTM Pro Software BD CellQuestTM Software

• Enter the sample volume, • Calculate SCE results using


dilution factor, and BD the statistics and equations
Trucount bead value in the provided.
expression editors to
obtain results.
35

Analyze the Acquired Data

Start Up Perform Optimize Acquire Analyze Shut Down


System QC Settings Data Data System

• Check each plot and verify that the gates are


properly placed.

• How do we identify the stem cells?


1. Identify viable cells.

2. Identify the leukocytes and lymphocytes.

3. Identify the CD34+ cluster among the viable cells.

4. Gate the Trucount Beads.


SCE Template in BD CellQuest Pro Software
1 2
1 Plots and Gates
For every sample, gates must be
checked and adjusted.

2 Expression Editors*
Enter values prior to acquisition.
- Trucount
- Dilution factor 3
- Sample volume
3 Gates & Statistics
Statistics are provided for
additional optional analysis.
4 SCE Results*
CQP automatically
provides SCE results.
4

• Expression editors and automatic


results are not available in BD
CellQuest software.
SCE Template in BD CellQuest Software
1
1 Plots and Gates
For every sample, gates must
be checked and adjusted.

2 Gates & Statistics


2
Statistics are provided for
additional optional analysis.

3 CD34+ SCE Equation


The equation enables
calculation of CD34+ cells/L .

3
• Expression editors and automatic
results are not available in BD
CellQuest software.
SCE Equations for BD CellQuest Software
Statistics provided in the Equations provided in the BD Stem Cell Enumeration
BD SCE CellQuest Template Application Guide for BD FACSCalibur Flow Cytometers
39

Gate List for Acquisition Template


40
SCE Analysis
• The BD SCE Kit acquisition and
analysis template is shown.

• Plot numbers (1–8) in orange


are shown for reference and do
not appear in the actual
template.
41

Verifying Viability Gate in Plot 8


a. Adjust R8:
42

Verifying Gates in Plots 1 and 6


b. Adjust R1:
c. Adjust R5 to include most of the lymphocytes.
d. Adjust R4 to include viable lymphocytes.
43

Verifying Gate in Plot 2

e. Adjust R2 to include all CD34+ events.


44

Verifying Gate in Plot 3


f. Adjust R3
45

Verifying Gates in Plots 4 and 6

g. Adjust R4
46

Verifying Gate in Plot 5


h. Adjust R6:
Optional: Adjust the quadrant marker to establish the lower
limit of CD45 expression by the CD34+ events, as in Plot 1.

CD34+
events

Red events
are 7-AAD
positive
(dead cells)
SCE Report in BD CellQuest Pro Software
SCE Report in BD CellQuest Software
49

Let’s Review. . .

What are the main steps in stem cell enumeration


on the BD FACSCalibur?
50
51

BD Stem Cell Enumeration Kit Highlights


52

Analyzing samples for CD34


Enumeration using BD FACSCanto II
Workflow Overview using BD FACSCanto II
Start Up Start up the system.
System Set up the software for SCE acquisition.

Stain the stem cell controls for instrument optimization


Perform and process control.
QC
Perform cytometer QC.

Optimize Perform instrument optimization with specific application


Settings setup (using a stem cell control).

Acquire Acquire process controls and verify results.


Data Stain and acquire samples.

Analyze
Analyze data and adjust gates as needed.
Data
Shut Down
Perform daily clean and shut down system.
System
54

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

• Perform fluidics startup in BD FACS Canto clinical software.


• Enter or confirm reagent lot IDs and acquisition targets.
55

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Perform QC with BD FACS 7-Color Setup Beads

• Track settings over time to


measure the cytometer’s
performance and consistency.

• Establish instrument settings that


are used as a starting point before
optimizing settings.
56

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Optimize Settings for BD Stem Cell Panel

• Optimize with either high or low


BD Stem Cell process control
tube sample (with 7-AAD).

• Confirm that spillover of 7-AAD


into PE is determined
successfully.
57

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Acquire process controls and confirm that they pass.

Tip: Confirm that the high and low process control results meet the
expected values for absolute CD34+ and %CD34+.
58

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

Acquire specimens.

Tip: Vortex each tube just prior to acquiring manually.


59

Workflow
Start Up Perform Optimize Acquire Analyze Shut Down
System QC Settings Data Data System

• Check each plot and verify that the gates are properly placed.

• How do we identify the stem cells?


1. Eliminate debris.

2. Identify viable cells.


3. Identify the leukocytes and lymphocytes.

4. Identify the CD34+ cluster among the viable cells.

5. Gate the Trucount Beads.


60

Review Gates
• Plot numbers (1 – 8) in orange are shown for reference and do not appear in the
actual SCE module.

• Letters (a – h) indicate the order in which gates should be verified.

1 2 3 4 5
e h
d f
g

6 7 8
c b

a
61
1. Identify debris in plot 6.

Identify debris in the lower left corner of the plot.


62

2. Identify viable events

Identify viable events in plot 8.


Use plot 7 to confirm the placement of the viable gate.
63

3. Identify lymphocytes in plot 1.

Identify lymphocytes among CD45+ events.


64

4. Identify stem cells.

Use plots 2 and 3 to identify stem cells.


65

4. Confirm the Viable CD34 Gate

Plot 4 displays the viable CD34 population.

Viable lymphocytes are shown in


light blue and viable CD34+ cells
are shown in red.
66

5. Identify beads

Confirm placement of the Trucount beads gate.


SCE Report in Canto Clinical Software
Header
Provides information on sample
ID, acquisition and analysis
times, and status.

Dot Plots
Display populations and gates

NOTE:
For process control lab reports,
the two viability data plots
(outlined here) are omitted.

Results

QC Messages
and Comments
68

Let’s Review. . .

What are the main steps in stem cell enumeration


on the BD FACSCanto II?
69

Let’s Review. . .

What are key advantages of the BD SCE Kit?


70

Let’s Review. . .
What are key advantages of the BD SCE Kit?

ISHAGE

PROCOUNT VS SCE
71

References
• Siena S, Castro-Malapina H, Gulati, SC, et. al. Effects of in-vitro purging with 4-hydroxycyclophosphamide on the
hematopoietic and micro –environmental elements of human bone marrow. Blood;1985:655-662.

• Siena S, Bregni M, Brando B, et. al. Flow Cytometry for clinical estimation of circulating hematopoietic progenitors for
autologous transplantation in cancer patients. Blood. 1991;77:400-409.

• Bender JG, Unverzagt K, Walker DE et. Al. Phenotypic analysis and characterization of CD34+ cells from normal human
bone marrow, cord blood, peripheral blood, and mobilized peripheral blood from patients undergoing autologous stem cell
transplantation. Clin Immunol Immunopathol. 1994 Jan;70(1):10-8.

• Sutherland DR, Keating A, Nayar R, et. al. Sensitive detection and enumeration of CD34+ cells in peripheral and cord blood
by flow cytometry. Ex. Hematol. 1994;22:1003-1010.

• Loken MP. Peripheral blood stem cell quantitation. In: Owens MA, Loken MP (eds) Flow Cytometry Principles for Clinical
Laboratory Practice Wiley-Liss: New York, 1995, pp 111-127.

• Sutherland DR, Anderson L, Keeney M, et. al. The ISHAGE guidelines for CD34+ cell determination by flow cytometry.
J Hematotherapy. 1996;5:213-226.

• Keeney M, Chin-Yee I, Weir J, et. al. Single platform flow cytometric absolute CD34+ cell counts based on the ISHAGE
guidelines. Cytometry. 1998;34:61-70.

• Dauber K., et al. Enumeration of viable CD34+ cells by flow cytometry in blood, bone marrow and cord blood: results of a
study of the novel BD ™ stem cell enumeration kit. Cytotherapy (2011) 13:449-458.

• Lemarie C., et al. A new single-platform method for the enumeration of CD34+ cells Cytotherapy (2009) 11(6):804–80

For In Vitro Diagnostic Use. CE marked to the European In Vitro Diagnostic Medical Devices Directive 98/79/EC.
Class I (1) Laser Products.
BD, BD Logo and all other trademarks are property of Becton, Dickinson and Company. © 2012 BD
23-14029-00
72

Q & A from the BD™ Stem Cell


Enumeration (SCE) Webinar

March 7, 2012
73

Q & A by Topic

1. BD Procount™ Kit vs BD SCE Kit


2. BD SCE Kit US Clinical Trial and EU Performance
3. BD SCE Kit Contents
4. Sample Types and Processing
5. Controls for the SCE Assay
6. Instruments Cleared for the SCE Kit
7. BD SCE Software
8. BD SCE Assay
9. Instrument Setup
10. Gating
11. Result Reports
1. BD Procount kit vs BD SCE kit 74

Q. Does the BD Procount kit use a different viability


reagent than the BD SCE kit?
Answer:
Yes, the BD Procount kit uses a nucleic acid dye to stain nucleated cells in
addition to the CD45 for the leucocytes. Since the BD Procount kit does not
contain the viability dye, it is not based on the ISHAGE guidelines. See the table
for additional differences.
2.BD SCE kit US clinical trial and EU performance 75

Q. Describe the results of the BD SCE kit US clinical trial


and EU performance evaluation.
Answer:
a. A total of 1,032 samples was tested across 8 sample types (fresh and
normal peripheral blood, frozen and thawed apheresis, bone marrow,
and cord blood) in the EU performance evaluation and the US clinical
trials.

b. The BD SCE reagent kit, templates, and application module results


were demonstrated to be substantially equivalent to the predicate
device.

c. The kit has been in use in Europe for over a year, and papers have
been published.*

*Dauber K, Odendahl M, Seifried E, Bonig H, Tonn T. Enumeration of viable CD34(+) cells by flow cytometry in blood,
bone marrow and cord blood: results of a study of the novel BD™ stem cell enumeration kit. Cytotherapy. 2011;4:449-
458.
3. BD SCE kit contents 76

Q. How many tests will the BD SCE kit run?


Answer:
The BD SCE kit contains components sufficient for 50
tests.
The use of process controls will reduce the total number of
tests within a kit; thus, the number of tests per kit will vary
based on the daily workload of the lab.
3. BD SCE kit contents 77

Q. Can I swap out antibodies in the kit for research use?

Answer:
The CD45 and CD34 antibodies are combined in the vial. It
is not possible to remove one without the other. BD does
not promote off-label use (use of a device or software not
covered in the manufacturer’s Instructions for Use).
4. Sample types and processing 78

Q. Have you validated different cord blood processing


methods such as HESPAN® solution and the
Prepacyte® processing system?
Answer:
BD does not have experience in methodologies for stem
cell collection and processing. BD worked with labs that
have developed and validated methods for cord blood
processing. The BD SCE kit was used with cord blood
specimens processed with different methods.
4. Sample types and processing 79

Q. Please reiterate what the 24-hour rule applies to.

Answer:
Freshly collected samples can be stored at 2° to 8°C for
up to 24 hours before staining.
4. Sample types and processing 80

Q. Can we detect the number of viable stem cells per


volume after thawing and washing frozen stem cell
samples?

Answer:
Yes, the kit is designed and used for this process.
4. Sample types and processing 81

Q. What is the longest acceptable elapsed time between


collection and running of a sample? We sometimes
receive samples that were collected more than 24
hours before.
Answer:
The BD SCE kit does not support the use of samples older
than 24 hours.
4. Sample types and processing 82

Q. What is the best way to process frozen cord blood


samples for stem cell enumeration?

Answer:
There are several protocols available for thawing frozen
stem cell specimens. See the Clinical and Laboratory
Standards Institute (CLSI) H42-A2 guidelines.*

*Enumeration of Immunologically Defined Cell Populations by Flow Cytometry;


Approved Guideline—Second Edition (H42-A2); Volume 18, No. 21.
4. Sample types and processing 83

Q. Have you done any studies of samples that have an


obvious hematogone* population?

Answer:
These cells are CD34+/CD19+. Hematagones are
generally not taken into account with the ISHAGE
protocol. Since hematagones are CD34+ and CD45dim,
they would be included in the CD34 enumeration because
there is no other marker or characteristic that would
exclude them from the gating.

*Hematogones are benign, immature B cells that commonly populate the bone marrow of children.
Their presence has been noted to interfere with the flow-cytometric analysis of cases of suspected
acute lymphoblastic leukemia (ALL) because their immunophenotype (positive for CD19, CD10,
CD34, and terminal deoxynucleotidyl transferase) is similar to that of pre-B cell lymphoblasts.
4. Sample types and processing 84

Q. Does the 24-hour rule apply to thawed samples?

Answer:
The 24-hour rule does not apply to thawed samples. They
must be stained as soon as possible and not longer than 1
hour after thawing.
4. Sample types and processing 85

Q. What are the critical aspects of sample handling and


preparation?
Answer:
a. Perform dilution of samples containing greater than 40,000
WBCs/µL, record the correctly calculated dilution factor, and
enter the dilution factor into the software.
b. Stain samples within 24 hours of collection.
c. Reverse pipette to ensure that an accurate volume of blood is
dispensed.
d. Maintain sample viability; this is important.
e. Use wet ice to store stained samples.
f. Acquire within 1 hour of staining (to limit toxicity of the
7-AAD viability dye and ammonium chloride lysing solution).
5. Controls for the BD SCE assay 86

Q. Are the two levels of controls sold with the BD SCE kit?

Answer:
No. The BD™ Stem Cell Control kit must be ordered
separately.
We recommend using the BD Stem Cell Control kit
(Catalog No. 340991) when using the BD SCE kit.
5. Controls for the BD SCE assay 87

Q. Must I run the two levels of controls daily? CD34 is


very expensive, and reimbursement from Centers for
Medicare & Medicaid Services (CMS) is low. This will be
hard to justify with our administration.
Answer:
a. College of American Pathologists (CAP) requires that two
levels of controls be run daily.
b. It is also good laboratory practice.
c. The Stem Cell Controls are used to optimize the
instrument settings.
5. Controls for the BD SCE assay 88

Q. Can I track the control values in a QC method?

Answer:
Yes, control values are automatically tracked in BD
FACSCanto™ clinical software using the Levey-Jennings
plots. To enable that feature, “Control” should be entered
in the Sample Name field for both the High and Low
controls.
6. Instruments cleared for the BD SCE kit 89

Q. Can the BD SCE kit be used with the BD LSRFortessa™,


BD™ LSR II, and BD FACSAria™ III flow cytometer?

Answer:
The BD SCE kit is IVD cleared for use with the
BD FACSCalibur™ and BD FACSCanto™ II flow
cytometers, both of which are also cleared for IVD use.
BD does not promote off-label use.
6. Instruments cleared for the BD SCE kit 90

Q. We use a BD FACScan™ system with BD CellQuest™


Pro software. Can the BD FACScan be used for this
assay?
Answer:
The BD SCE kit is IVD cleared for use with BD CellQuest™
or BD CellQuest Pro software on the BD FACSCalibur flow
cytometer.
BD does not promote off-label use.
7. BD SCE software 91

Q. Is there software for the BD SCE kit?

Answer:
Yes.
For BD FACSCanto II users, the BD™ SCE software module
for BD FACSCanto clinical software v2.4 is needed.
For BD FACSCalibur users, BD CellQuest or BD CellQuest
Pro templates are needed.
Please contact BD customer service or your local sales
representative about how to obtain CDs.
7. BD SCE software 92

Q. Can I use the BD SCE module on a BD FACSCanto™


flow cytometer?
Answer:
The BD SCE kit is FDA cleared for use on the BD FACSCanto II and
BD FACSCalibur systems. Running the BD SCE kit on a
BD FACSCanto system is considered off-label use.

When the BD SCE module is installed on a BD FACSCanto system, a


warning message is displayed during installation and the lab reports
always indicate “RUO – Research Use Only.” The individual lab must
validate its results.
8. BD SCE assay 93

Q. We currently use 1 mL of lysing solution. Why do we


need 2 mL?

Answer:
The 2 mL of lysing solution is specified in the ISHAGE
protocol created by Sutherland et al,* and this is how BD
validated the use of the kit.

*Sutherland DR, Anderson L, Keeney M, Nayar R, Chin-Yee I. The ISHAGE Guidelines


for CD34+ Cell determination by flow cytometry. J Hematother. 1996;5:213-226.
9. Instrument setup 94

Q. Can the BD FACS™ Loader be used?

Answer:
No. Due to temperature requirements of the assay, samples
must be acquired manually. 7-AAD and ammonium chloride
are toxic to cells. Therefore, cell viability of stained SCE
samples decreases over time. Store stained samples in a
wet ice bath to maintain viability and acquire samples within
1 hour of staining.
9. Instrument setup 95

Q. Can BD™ CS&T beads be used for setting up the


BD FACSCanto II for the BD SCE assay?

Answer:
No. The assay is designed such that BD FACS™ 7-Color
Setup beads must be run, since compensation is
generated with these beads. BD™ Cytometer Setup and
Tracking (CS&T) beads do not generate any compensation
values and are not compatible with BD FACSCanto clinical
software. Immediately after running your 7-Color Setup
beads, the optimization for the BD SCE assay needs to
be performed.
9. Instrument setup 96

Q. Can we optimize the BD FACSCalibur for the BD SCE assay


and then save the settings as instrument settings? We could
then move to the Leukemia/Lymphoma panels and then come
back to the BD SCE assay at the end of the day.

Answer:
Yes, the sequence of running both the lyse/no-wash (LNW)
and lyse/wash settings using BD FACSComp™ software
can be done. The BD SCE assay settings could then be
optimized in BD CellQuest software, and those instrument
settings saved. Finally, the Leukemia/Lymphoma settings
could be optimized and saved.
9. Instrument setup 97

Q. My lab runs different panels in BD FACSCanto clinical


software. How do I optimize for all the panels?

Answer:
Perform setup using 7-Color Setup beads. Ensure that it
passes. Perform stem cell optimization. Then proceed with
optimizing for the remaining panels. Always perform stem
cell optimization immediately after setup with 7-Color
Setup beads.
9. Instrument setup 98

Q. Do you need to do multiple runs of the compensation setup?


The scenario:
1. Start up the BD FACSCanto II cytometer and BD FACSCanto
clinical software and run 7-color setup and stem cell optimization.
2. Acquire stem cell samples.
3. Exit BD FACSCanto clinical software and start
BD FACSDiva™ software.
4. Restart BD FACSCanto clinical software.
5. Acquire stem cell samples? Or re-run 7-Color Setup beads and
compensation?

Answer:
You can run samples later after exiting and restarting as long as the
7-color setup and the panel-specific optimization are completed within
24 hours. If 7-color setup is run again later on, then the panel-specific
optimization has to be run again.
9. Instrument setup 99

Q. What is the acceptable range for PE-%7-AAD spectral


overlap?

Answer:
a. In BD FACSCanto clinical software, a value between -0.5%
and 10.5% indicates a successful setup optimization.
b. For the BD FACSCalibur, add 4 to the FL3-%FL2 value
obtained from running a 3- or 4-color LNW setup.
9. Instrument setup 100

Q. Are all acquisition settings in the BD SCE acquisition


template applied simultaneously?

Answer:
No. Use the Debris gate (R7) for the Acquisition Rejection
Gate. Use 75,000 Viable CD45 for the collection criterion.
Once the sample is acquired, check that 1,000 BD
Trucount™ beads and 100 viable CD34 cells have been
acquired. If these collection criteria are not satisfied, re-
acquire the sample with the collection criterion set to 100
viable CD34. There is a maximum acquisition time of 900
seconds (15 minutes).
9. Instrument setup 101

Q. Are all acquisition settings in the BD SCE module for


the BD FACSCanto II applied simultaneously?

Answer:
Yes. Before acquisition, check that the acquisition settings
are defined as: 75,000 viable CD45, 125 viable CD34, and
1,000 BD Trucount beads. The maximum acquisition time
is 900 seconds (15 minutes).
9. Instrument setup 102

Q. What is the BD FACSCanto II threshold? Can I change


it?

Answer:
The threshold in the BD FACSCanto II SCE module is set
to FITC 400 and cannot be changed.
10. Gating 103

Q. We currently use a plot to gate on singlet beads plotted


over time. Is there any accommodation for this?

Answer:
Please do not make any changes to the template. Plotting
for singlet beads is not recommended for BD Trucount
beads because all the beads are included in the count at
the factory. Results will be inaccurate if you eliminate the
doublets.
10. Gating 104

Q. Please walk me through the sequential gating that is


used for the BD SCE assay.
Answer:
When using the BD FACSCalibur, a series of regions
and gates is utilized to enumerate the CD34 cells. First
the cells must be viable as defined in R8 in plot 8.
Then we look at the CD45 staining (plot 1) on the
leucocytes in the sample. Some debris may be
excluded, yet too much cannot, to avoid removing the
stem cells. Then we look at the lymphocyte gate, R5
(plot 1). From there we move to the Forward Scatter vs
Side Scatter as displayed in plot 6. This R4 region is
adjusted to capture the cluster of lymphocytes. We then
move to the CD34 vs Side Scatter, plot 2, to capture
the CD34+/CD45+ cells. This sequential gating now
specifies that to be a viable CD34+ stem cell, the event
must be viable (R8), CD45+ (R1), Forward Scatter as
gated (R4), CD34+ (R2), and CD45 vs Side Scatter
(R3).
10. Gating 105

Q. What is the population that is 7-AAD positive in plot 7?

Answer:
Plot 7 displays only CD34 events, so the 7-AAD positive
events are CD34 dead events. The ratio between the
negatives and positives on this plot gives the viability
value.
10. Gating 106

Q. There are too many events to set the viability gate in


plot 8. What should I do?
Answer:
Display fewer % of events.
10. Gating 107

Q. Why is the R7 debris gate not included in any of the


other gate definitions?

Answer:
R7 is an exclusion gate; events in R7 are excluded from
the data file. R7 should not exceed FSC and SSC 200.
10. Gating 108

Q. Why doesn't the Total CD34 gate include R4?

Answer:
The total CD34 does not include R4 because some of the
dead stem cells are outside this region. R4 identifies the
healthy lymphocytes or healthy stem cells.
11. Result reports 109

Q. We need to know the total viability of the sample. How


is that done?

Answer:
The BD SCE templates (BD CellQuest or BD CellQuest
Pro) and the SCE acquisition and analysis module (BD
FACSCanto II) do not provide this information.
11. Result reports 110

Q. There is no plot showing total CD34 events to adjust the gate.


We find that the total CD34 event count is higher than the
viable CD34 events. Since the ISHAGE protocol reports out only
the viable CD34 count, a total CD34 count is not displayed or
reported.

Answer:
Total CD34 events are displayed on plot 7 with the
live/dead discriminating gate. The total CD34 cell count
cannot be lower than the viable CD34 cell count.
11. Result reports 111

Q. How can I add the patient’s body weight to a report?

Answer:
In the BD SCE module for BD FACSCanto clinical
software, information can be added to the Comments
section of the Lab Report.
112

For additional troubleshooting assistance, see the Stem Cell


Enumeration Application Guide for the BD FACSCanto II
Flow Cytometer or the Stem Cell Enumeration Application
Guide for the BD FACSCalibur Flow Cytometer.

HESPAN is a registered trademark of B. Braun Medical.


Prepacyte is a registered trademark of Bio E Inc.
BD, BD Logo and all other trademarks are property of Becton, Dickinson and Company. © 2012 BD
113

If you have further questions, please visit:


www.bdbiosciences.com/askbd

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