Technological Evolution of Flow Cytometry in Oncology and Immunology

05 Dec 2022

The healthcare industry frequently pioneers breakthrough technology, employing novel methods for disease prevention and effective treatment solutions. In fact, current technological developments are assisting in the resolution of critical healthcare issues, such as clinical training, data management, and cancer care.

According to the World Health Organization, cancer is the second biggest cause of disease burden and mortality worldwide, and cancer accounted for nearly 10 million deaths in 2020. Methods for cancer prevention, diagnosis, and treatment are still a global effort.

The global increase in the cancer burden has significantly increased the need for flow cytometry in oncology to conduct screening and therapeutic monitoring during cancer treatment. Currently, one of the widely used screening techniques in the fields of immunology and oncology is flow cytometry. 

This technique enables medical practitioners to categorize the different types of cells in a heterogeneous cell population by examining cellular expressions at the cellular level. Due to its underlying clinical usefulness, particularly for hematological malignancies, screening, diagnosis, treatment monitoring, and relapse risk assessment, this technique has attracted a great deal of interest from medical professionals.

The use of flow cytometry in oncology provides excellent diagnostic opportunities for most hematologic and oncologic ailments by providing various cellular and molecular details about a single cell. 

Therefore, driven by factors such as the increasing burden of cancer, expansion of applications in flow cytometry for research activities, innovation in flow cytometry leading to the use of next-generation flow cytometers, and the increasing use of flow cytometry in the identification and diagnosis of immune-deficiency diseases, the use of flow cytometry in oncology and immunology market is expected to grow significantly. 

According to the BIS Research report, the global flow cytometry in oncology and immunology market was valued at $1.65 billion in 2021 and is anticipated to reach $5.28 billion by 2032, witnessing a CAGR of 11.39% during the forecast period 2022-2032. 

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Since the origin of flow cytometry, the technology has made significant leaps and improved efficiency to make the contribution that it has made to the field of oncology and immunology. This article goes into further detail about the origin of the technique and the current developments in terms of research and technology. 

Origin of Flow Cytometry in Oncology 

Wallace H. Coulter, an electrical engineer, invented the technology that would allow for the counting, categorization, detection, and analysis of the chemical and physical features of moving cells and particles in fluid in the late 1940s. With the development of the first fluorescence-based flow cytometry tool in the late 1960s, Wolfgang Göhde, a researcher at the University of Münster (Germany), established the field of flow cytometry. 

Initially, flow cytometry, also known as pulse cytophotometry, could count and examine a limited number of cells using a limited set of parameters. These days, this technology is capable of quickly and in real-time analyzing hundreds of cells (measured with more than 20 parameters) and producing extremely precise results. 

Current Developments in Flow Cytometry in Oncology and Immunology

Currently, significant research is being conducted about the possible use of flow cytometry in oncology research and application. Even though it has long been a recognized tool for the diagnosis of immunological and cancerous disorders, due to underlying technical constraints, there is still a severe unmet demand for the application of flow cytometry for solid tumors in routine clinical settings.

Nevertheless, organizations such as bioAffinity Technologies Inc. are consistently trying to fill the gap in clinical care caused using flow cytometry in the diagnosis of cancers such as solid tumors and lung cancer. For instance, CyPath Lung, a flow cytometry-based laboratory-developed test (LDT) created by the firm, successfully examines cells found in phlegm or sputum to identify malignant cells. By aiding in the early detection of lung cancer, this test gives doctors the opportunity to treat patients with targeted therapies.

To improve clinical outcomes, ongoing investigations are being conducted all over the world to ascertain the connection between patient immunotherapy monitoring and the use of flow cytometry in cancer diagnosis.

For instance, according to a paper published in the NCBI in 2021 and titled "Flow Cytometry Immunophenotyping for Diagnostic Orientation and Classification of Pediatric Cancer Based on the EuroFlow Solid Tumor Orientation Tube (STOT)," the use of flow cytometry for diagnostic and screening of solid pediatric tumors may help to expedite and accurately diagnose and classify pediatric cancer in routine clinical practice.

Thus, it is projected that in the years to come, attractive opportunities will arise as research into the use of flow cytometry in solid tumor applications continues to advance and as companies shift their attention to the development of novel flow cytometry-based products.

Apart from the research, currently, flow cytometry technology is divided into two categories; these two techniques are discussed as follows: 

1.    Cell-Based Flow Cytometry: Cell-based flow cytometry technologies count the number of antibodies present in the cells by using antibody-fluorophores conjugates. This technology takes advantage of the fact that cell membranes are light-permeable to give doctors precise clinical information, especially regarding hematological malignancies.

Using cell-based technologies in flow cytometry, the absolute fraction of cells in the sample is calculated. The use of flow cytometry in conjunction with this technique allows for the immunophenotypic detection of MRD, which examines each individual cell in the sample to evaluate whether it has antigens linked to hematologic neoplasms.

Due to the inclusion of the cell-based flow cytometry technique, which is primarily based on the level of fluorescence generated by each cell, researchers and medical professionals can now directly assess specific targets of interest in each cell. Such advancements in the field of flow cytometry are anticipated to strengthen the sector and support the growth of the global market for cancer and immunology applications of flow cytometry.

2.    Bead-Based Flow Cytometry- The specimens and beads used in bead-based flow cytometry technologies are paired with target-specific antibodies. The conjugated bead precisely binds to the antigen and localizes the fluorescent antibodies to the antigen's surface once fluorescent antibodies are introduced for binding to the antigen location. 

The laser beam transmits the fluorescent antibody-antigen conjugate during flow cytometry analysis, which generates information based on light's forward and side scattering.

The use of bead-based flow cytometry techniques allows the identification of the absolute cell count in terms of numbers. For enhancing the precision of cancer diagnosis and therapy management to produce clinical outcomes that are appreciated, bead-based flow cytometry holds out a lot of potential. 

Moreover, the application of the bead-based flow cytometry approach has shown promising diagnostic outcomes in successfully detecting fusion proteins in samples taken from patients with hematologic neoplasms.


Numerous advancements in flow cytometry have made it possible to conduct an increasing number of cancer research studies. These investigations have shed important light on the cellular micro-environment of cancer, aiding in the identification of crucial characteristics that can be utilized in the clinical therapy of cancer. The development of multiparametric and next-generation flow cytometry technologies for cancer diagnostic testing is another area in which manufacturers are heavily spending on research and development (R&D).

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