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Flow Cytometry Test for Minimal Residual Disease (MRD) in CLL: Booking, Price, and Results

About Flow Cytometry Test for Minimal Residual Disease (MRD) in CLL

Field	Value
Also Known As	MRD flow cytometry for CLL, CLL MRD panel, MRD assessment by flow cytometry, CLL MRD test, Minimal residual disease test for CLL, Flow cytometry MRD for CLL.
Sample Type	Bone marrow aspirate/ peripheral blood
Fasting Required	No fasting required
Report Time	4 Days
Recommended For	Adults diagnosed with chronic lymphocytic leukemia who have completed treatment, to assess treatment response and monitor for residual disease.
Price	Starting at ₹18,000

What is a Flow Cytometry Test for Minimal Residual Disease (MRD) in CLL?

Flow cytometry test for minimal residual disease (MRD) in CLL is a highly sensitive laboratory test used to detect very small numbers of residual Chronic Lymphocytic Leukaemia cells that may remain in the body after treatment. CLL is a type of blood cancer that affects white blood cells called lymphocytes. This test uses flow cytometry to identify abnormal leukaemia cells that may not be detectable through routine blood tests or standard microscopic examination. This test is also known as the CLL MRD test, minimal residual disease test for CLL, or flow cytometry MRD for CLL. A doctor may advise this test after chemotherapy, targeted therapy, immunotherapy, or stem cell transplantation to evaluate treatment response, assess remission status, and monitor the risk of disease recurrence.

What Does a Flow Cytometry Test for MRD in CLL Measure?

The MRD test identifies specific proteins on the surface of CLL cells to detect and count any remaining cancer cells with great sensitivity. The following markers and measurements are commonly analysed during the test.

Parameter	What It Represents
CD19, CD20, CD5, CD43, CD79b, CD81	Surface proteins used to identify CLL cells
B-cell immunophenotype	The characteristic surface protein pattern of CLL cells
Residual CLL cell percentage	The proportion of remaining abnormal CLL cells in the sample
MRD sensitivity level	Detection sensitivity, often as low as 1 CLL cell among 10,000 or more normal cells (10⁻⁴)

Why is a Flow Cytometry Test for MRD in CLL Done?

This test is ordered when a doctor needs to know how many CLL cells, if any, remain in the body after treatment. It provides information that goes beyond what routine testing can offer.

Common Symptoms That May Require This Test

A doctor may order this test when a CLL patient has been treated and presents with any of the following:

Persistent fatigue even after completing treatment.
Frequent or recurring infections
Swollen lymph nodes in the neck, armpits, or groin.
Breathlessness or headaches related to anaemia (low red blood cell count).
Easy bruising or bleeding due to low platelet levels.
Signs that suggest disease may still be active despite apparent remission.

Conditions This Test Can Help Detect

The NLR test procedure can help your doctor identify or monitor a range of conditions, including:

Presence of residual CLL cells after treatment (even when the patient appears to be in remission).
Risk of disease recurrence or relapse.
Incomplete response to chemotherapy or immunotherapy.
Treatment effectiveness as part of ongoing disease management.

Flow Cytometry Test for MRD in CLL for Chronic Disease Monitoring

This test is recognised as an independent marker for predicting how well a CLL patient is likely to do over time. Achieving MRD-negative status after treatment is associated with longer periods without disease progression and better overall survival. Experts recommend testing at a minimum of two months after completing fixed-duration therapy, with possible repeat testing at 12-week intervals to confirm sustained remission.

How to Prepare and What to Expect

Do You Need to Fast?

No, fasting is not required before this test. You can eat and drink normally before the appointment.

Practical Tips Before Your Test

Bring a detailed clinical history, including your symptoms, previous laboratory and bone marrow reports, diagnosis details, and current or prior treatment information, as these are important for accurate test interpretation.
Inform your doctor about all ongoing medications, especially chemotherapy, immunotherapy, or any targeted therapies such as BTK inhibitors.
Bring a recent complete blood count (CBC) report if one is available.
Inform your doctor about any anti-CD19 or anti-CD20 antibody therapies you have received, as these may affect certain cell markers.
Stay well hydrated on the day of collection, as this makes sample collection easier.

Step-by-Step Procedure

The bone marrow sample for this test is collected at a hospital or clinic by a trained haematologist.
You will be asked to share your clinical history and recent treatment details before the procedure begins.
A haematologist will collect a bone marrow aspirate sample usually from the hip bone (iliac crest) using a specialised needle. A local anaesthetic is used to minimise discomfort.
The sample is collected into an EDTA tube.
If a peripheral blood sample is advised, a healthcare professional will draw blood from a vein in your arm using a sterile needle and collection tube.
After collection, the puncture site is covered with a small dressing.
The sample is stored at 2 to 8 degrees Celsius and must be transported to the laboratory promptly, as it must be processed within 72 hours of collection.
In the laboratory, the sample is analysed using multiparameter flow cytometry, where fluorescent-labelled antibodies are used to identify and count any remaining CLL cells.

Factors That Can Affect Accuracy

Haemodilution during bone marrow collection (mixing of blood with the aspirate), which can lead to an underestimation of residual disease.
Recent anti-CD19 or anti-CD20 targeted therapy, which may reduce or alter marker expression.
Sample age, clotting, or haemolysis if the specimen is not processed promptly.
Low cell numbers in the sample, which can reduce the sensitivity of the test.
Timing of the test relative to treatment completion.

Understanding Your Flow Cytometry Test for MRD in CLL Results

Your results indicate whether residual CLL cells were detected in the sample and at what level. Always review your results with your treating haematologist.

Result Category	Threshold	Interpretation
MRD-Negative (Undetectable)	Below 10⁻⁴ (fewer than 1 in 10,000 cells)	No detectable residual CLL cells at the sensitivity level tested
MRD-Positive (Detectable)	At or above 0.01% CLL cells	Residual cancer cells are present in the sample
MRD4 sensitivity level	10⁻⁴	1 CLL cell detected per 10,000 white blood cells
MRD5 sensitivity level	10⁻⁵	1 CLL cell detected per 100,000 white blood cells
MRD6 sensitivity level	10⁻⁶	1 CLL cell detected per 1,000,000 white blood cells

These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.

Results During Special Conditions

Patients who have received CD19-targeted therapies or BTK inhibitors may show reduced or absent CD19 expression, and alternative markers such as CD40 may be used instead.
Recent monoclonal antibody therapy can interfere with specific cell markers, and your doctor will factor this in when reviewing results.
Haemodilution during bone marrow sample collection can cause the residual disease level to appear lower than it actually is, potentially giving a false-negative impression.
Samples with low cell counts may reduce the overall sensitivity of the test.

How to Support Your Health During Treatment

Follow your haematologist's recommended treatment and follow-up schedule consistently.
Attend all scheduled appointments and do not skip repeat MRD assessments.
Report any new or returning symptoms, such as unexplained fatigue, swollen lymph nodes, or frequent infections, to your doctor promptly.

Lupin Diagnostics Flow Cytometry Test for MRD in CLL Price and Booking

The MRD test cost at Lupin Diagnostics starts at ₹18,000. Home collection is not available, as bone marrow collection requires a hospital or clinic setting.

City	Approximate Price (₹)
BHOPAL	18000
CHENNAI	18000
HYDERABAD	18000
KOLKATA	18000
NAVI MUMBAI	18000
PUNE	18000

Prices are indicative and may vary by location. Please confirm the current price at the time of booking.

How to Book

Select the test on the Lupin Diagnostics website.
Choose your city and preferred centre location.
Visit the centre at your scheduled time for sample collection by a trained clinical professional.
Receive your report via email or WhatsApp within 04 days of sample collection.

Frequently Asked Questions

MRD refers to very small numbers of leukaemia cells that may remain in the body after treatment, at levels too low to detect with standard blood tests. The flow cytometry test for MRD in CLL uses highly sensitive technology to find even a single cancer cell among tens of thousands of normal cells. It helps doctors understand how effectively treatment has worked.

A routine blood test can tell your doctor how many white blood cells, red blood cells, and platelets are in your blood, but it cannot detect very small numbers of cancer cells. The MRD test procedure uses fluorescent-labelled antibodies and flow cytometry to identify CLL cells at an extremely low level, giving a far more precise picture of residual disease.

An MRD-negative result means residual CLL cells were not detected above the laboratory reporting threshold per 10,000 white blood cells in the sample tested. This is associated with a better prognosis, a longer period without disease progression, and improved overall survival. Your haematologist will explain what this means for your specific situation.

Not necessarily. An MRD-positive result means that a small number of CLL cells were detected, but this does not automatically indicate full relapse. Your doctor will consider this alongside your symptoms, clinical examination, and other test results before deciding on next steps.

The general recommendation is to test at least two months after completing a fixed course of treatment. After that, your doctor may recommend repeat testing at roughly 12-week intervals to monitor your response over time. Your individual schedule will depend on your treatment plan and how your disease is responding.

Yes. Therapies that target CD19 or CD20 proteins on CLL cells, including certain monoclonal antibodies and BTK inhibitors, can alter the expression of these markers. This may affect interpretation of the results. Always inform the laboratory and your doctor about all treatments you have received so that results are interpreted correctly.