Flow Cytometry + PARR for Canine Lymphoma & Leukemia

Immunoprofile

The ImpriMed Immunoprofile report includes both our complete PARR and Flow Cytometry results as well as an expert diagnostic interpretation. This combined service provides both clonality and immunophenotype information that enable you to definitively diagnose the presence and subtype of lymphoma and leukemia.

Get immunophenotyping information
in 3-4 calendar days*

What's included:

1. Flow cytometry
Our panel of 10 antibodies optimized for blood cancers provides you with critical diagnostic and prognostic information.

2. PARR (PCR for Antigen Receptor Rearrangement) helps you discriminate between a lymph node that is cancerous and one that is swollen due to infection. This test provides detailed information about the expansion of B-cell and T-cell clones.

Sample Collection

For Lymphoma: Fine needle aspirate from swollen lymph node(s) + 2 mL blood in an EDTA tube
For Leukemia: 2 mL blood in an EDTA tube
Illustration of a golden retriever asking question

Why should I order the Immunoprofile service instead of stand-alone Flow Cytometry or PARR?

By ordering both flow cytometry and PARR together, you can get a more comprehensive view of the patient's lymphoma from the start. Flow cytometry can identify the type of lymphoma and its degree of malignancy, while PARR can confirm the diagnosis and detect even small numbers of malignant cells. Combining these two techniques can help to provide a more accurate diagnosis and a better understanding of the patient's disease, which can ultimately guide treatment decisions and provide better prognostic information. 

*After the receipt of the sample at the lab in California

Our science sets us apart

Pioneers in AI-driven Drug Response Predictions
We are proud to be at the forefront of the latest advancements in artificial intelligence and veterinary medicine. We take science-forward and data-driven approaches in providing accurate and reliable predictions to help veterinary oncologists make informed treatment decisions. We share your passion for helping cancer patients and take pride in providing you with the best user experience, customer service, and clinical decision support in the industry.

A2LA accredited
Your patient’s sample analysis is performed in a US laboratory that is accredited to meet A2LA standards. An A2LA-certified lab must meet high standards of quality and ensure the accuracy and reliability of your results. ImpriMed is accredited by A2LA for Canine Lymphoma/Leukemia Clonality Testing by PCR for Antigen Receptor Rearrangements (PARR) and Immunophenotyping by Flow Cytometry.

How It WOrks

Illustration of a mailer box filled with ImpriMed's proprietary transport media tubes
1. Request Media Tubes

Fill out the form below to request media tubes. And register on our Vet Portal to order our services.

Illustration of a mailer box filled with ImpriMed's proprietary transport media tubes
2. Collect FNA & Blood Samples

Collect an FNA from lymph node(s) and transfer the cells into our transport medium plus 2 mL of whole blood in an EDTA-treated tube.

Guide to sampling: Click here to see the video

3. Order Service & Ship Samples

Through your account on our Vet Portal, select services needed. Make sure you provide information about your patient and samples on our online portal. Pack the collected samples (FNA and blood) with ice packs and then ship them to ImpriMed using the boxes and FedEx labels provided.

A veterinarian reviewing ImpriMed's service report to give a personalized treatment to her patient
4. Check Your Email

The final report is emailed to the ordering oncologist in 3-4 days via secure email.

Ready to get started with ImpriMed?

Sign up Today

Try ImpriMed

To get started, fill out the form and we will send our proprietary transport media tubes to your clinic.

Illustration of a mailer box filled with ImpriMed's proprietary transport media tubes

Book a meeting with us

Select a date & time below to schedule a live virtual meeting with our sales team.

Frequently asked questions

For Veterinarians

What services does ImpriMed offer?

ImpriMed offers personalized medicine services to help you diagnose and treat canine lymphoma or leukemia.  We offer 4 levels of service:

Service Name
Clinical Use
Tests performed
Personalized Prediction Profile
anticancer drug selection + lymphoma/leukemia diagnosis and subtyping
live-cell drug sensitivity testing + flow cytometry + PARR
Drug Response Predictions
anticancer drug selection
live-cell drug sensitivity testing
Immunoprofile
lymphoma/leukemia subtyping
flow cytometry + PARR
Flow Cytometry Only
lymphoma/leukemia subtyping
flow cytometry
PARR Only
lymphoma diagnosis
polymerase chain reaction for antigen receptor rearrangements (PARR)

What does the ImpriMed Personalized Prediction Profile include?

  • The Personalized Prediction Profile includes our complete Immunoprofile diagnostic report and anticancer drug response predictions generated by artificial intelligence models.
  • The predictions include estimates of both (1) the likelihood of a positive clinical response (partial response/ complete remission) to individual anticancer drugs and (2) the likelihood of complete remission and relapse with traditional CHOP combination therapy.
  • Outcome predictions are currently provided for 13 individual drugs that are commonly used in many first line and rescue protocols for the treatment of canine lymphoma (including CHOP, LOPP, MOPP, LPP, Tanovea® only, etc…).
  • Predictions are included for Doxorubicin, Cyclophosphamide, Vincristine, Vinblastine, Prednisone, Rabacfosadine (Tanovea®), L-Asparaginase, Lomustine, Mitoxantrone, Mechlorethamine, Dexamethasone, Chlorambucil, and Melphalan.

Which drugs are included in the ImpriMed Personalized Prediction Profile?

  • For our canine lymphoma and leukemia service, we expose the live cancer cells to 13 different commonly used drugs: L-Asparaginase, Mitoxantrone, Vincristine, Vinblastine, Doxorubicin, Rabacfosadine (Tanovea®), Chlorambucil, Mechlorethamine, Lomustine, Prednisolone (activated Prednisone), Mafosfamide (activated Cyclophosphamide), Melphalan, and Dexamethasone.

What is included in the ImpriMed Immunoprofile service?

  • The ImpriMed Immunoprofile service includes both our Flow Cytometry and PARR reports.
  • These comprehensive results can be used to detect the presence of lymphoma or leukemia and determine the disease subtype.

Why should I order ImpriMed services?

  • ImpriMed offers a unique precision oncology service that helps you to find the best anticancer drugs for your patients.
  • ImpriMed directly tests a panel of commonly used anticancer drugs on your patients’ live cells in our A2LA accredited lab.¹
  • In addition, we continually collect patient outcomes that are updated via regular follow-up with pet parents.
  • As our database grows, so does the performance of our anticancer drug response predictions and your ability to develop a personalized treatment plan for each pet patient.
  • So, when you order an ImpriMed service, you are actively contributing to our dataset and helping to improve cancer care for your patients and the ImpiMed user community.

What is a drug sensitivity test?

  • A drug sensitivity test is a lab test that measures how easily cells are killed by a drug.
  • When you order a Personalized Prediction Profile, ImpriMed uses a proprietary high-throughput ex vivo drug sensitivity testing platform to analyze your patient’s live cells.
  • For our canine lymphoma and leukemia service, we expose the cells to 13 different drugs commonly used to treat these diseases: L-Asparaginase, Mitoxantrone, Vincristine, Vinblastine, Doxorubicin, Rabacfosadine (Tanovea®), Chlorambucil, Mechlorethamine, Lomustine, Prednisolone (activated Prednisone), Mafosfamide (activated Cyclophosphamide), Melphalan, and Dexamethasone.

Which cancers can I use ImpriMed for?

Currently, our services are for canine lymphoma and leukemia.  We will be expanding our services to other species and other blood/lymphoid cancers in the near future.

How does ImpriMed predict drug responses?

  • Our predictions are made by artificial intelligence (AI) models trained to predict clinical outcomes from patient data inputs.
  • Clinical outcomes collected from oncologists include reports of progressive disease, stable disease, partial response, and complete response.
  • Patient data used as inputs for by the AI models include readings from our live-cell drug sensitivity assay, flow cytometry, PARR, and patient information.
  • Models are re-trained periodically to incorporate new data and refine performance.

How long until I get my ImpriMed report?

  • Our flow cytometry, PARR, and Immunoprofile reports are emailed to you 3-4 days after receipt of your patient’s sample(s)at our lab.
  • The Personalized Prediction Profile reports are emailed to you 6-7 days after receipt of your patient’s sample(s) at our lab.

How do I order an ImpriMed service?

  • To get started, first register on our Vet Portal. You can order both services and supplies online: https://www.imprimedicine.com/vetportal
  • For portal support via phone call us at 650-521-0165 or for support via email please write to us at [email protected]
  • We will send you a starter kit (transport media tubes, prepaid shipping boxes, and packing materials) within 1 business day.
  • Once you’ve received the kit and materials you are ready to go; you can collect patient samples and ship them to ImpriMed via FedEx overnight. We are open 6-days a week to accept samples (Monday through Saturday).

What patient samples are required for ImpriMed services?

  • For canine lymphoma, please provide a fine need aspirate (FNA) sample and a blood sample for each patient.
  • For canine leukemia, only a blood sample is required.

How do I collect an FNA sample?

 ImpriMed steps for FNA collection – Please watch the video here or read on

  1. Disinfect the skin with alcohol (70%) at the planned needle puncture site.
  2. Insert a 20-gauge needle (without syringe) into an enlarged lymph node and perform 15 - 20 aspirations using an aggressive “woodpecker style” technique. Stop aspirating when the aspirate appears in the hub of the needle.
  3. Attach the needle to a 5 - 10 mL syringe (with at least 1 ml of air). Tilt the collection tube upside down and inject the aspirated material directly into the medium.
  4. Allow a small amount of fluid (~1/4 mL) to flush back into the needle, then gently reinject into a fluid medium to flush out the needle.
  5. Repeat the procedure multiple times to ensure all the aspirate is transferred into the media tube. We need at least 10 million cells to conduct the drug response predictions, so if you need to aspirate from other affected nodes please do so. There are no additional costs for additional nodes or tubes. Typically, 2 FNA tubes of adequate cellularity are required to reach 10 million cells. If a blood vessel was lacerated during the procedure and the collection tube becomes significantly bloody, please select a different biopsy site and repeat the procedure. Store any FNA tubes in the fridge immediately after the biopsy. DO NOT freeze samples or the transport media.
  • We also accept fresh lymph node tissue and spleen samples (within 24 hours of collection).

How many cells are needed for each type of service?

The cell counts required for each assay are below:

  • Personalized Prediction Profile or Drug Response Predictions: 10 million
  • Immunoprofile: 1 million
  • Flow cytometry: 700,000
  • PARR: 300,000

For more information on lymph node cytology click here: https://todaysveterinarypractice.com/lymph-node-cytology-what-should-should-not-be-there/

What does flow cytometry tell me about my patient’s specimen?²

  • ImpriMed’s flow cytometry report provides comprehensive information about the specimen’s immunophenotype.
  • B-cell and T-cell immunophenotypes are useful in determining lymphoma/leukemia subtype and prognosis.
  • In addition, our panel of ten antigens can also be used in the diagnosis of T-zonal lymphoma, acute leukemia, and other diseases.
  • Antigens levels reported are: CD21, CD79a, CD3, CD4, CD8, CD5, CD45, CD34, CD14, and MHC class II.

For more information, see: https://pubmed.ncbi.nlm.nih.gov/26953614/

What does PARR tell me about my patient’s specimen?

  • PARR, which stands for PCR for Antigen Receptor Rearrangements, is used to discriminate between lymphoma/leukemia and reactive/inflammatory conditions when cytology is equivocal.
  • Our canine PARR assay detects the expansion of B-cell cancer clones by amplifying the VJ region of the immunoglobulin heavy chain gene (IgH) and detects the expansion of T-cell cancer clones by amplifying a region in the T-cell receptor gamma chain gene.³

How can I help to advance precision medicine?

  • The more samples ImpriMed processes and the more clinical outcomes we receive from our customers, the more accurately our AI models are able to determine which drugs will work best for your patients.
  • If you believe the ImpriMed Personalized Prediction Profile may help you to identify the most effective treatments for a patient, be sure to notify the pet parents that this service is an option for them.
  • One of the huge benefits of AI-led diagnostics like ImpriMed is the ability to be constantly developing and improving based on the feedback of existing cases. This prospective approach to the evolution of the assay improves the accuracy and therefore the applicability for all patients. Because of this philosophy to constantly improve the service; we try to reach out to our clients a few months after a test is run to gather basic data on how the test performed. We have developed a simple standardized form to make this as easy as possible and we appreciate your support in advance. If you have any concerns over the test, this ensures we can address them to help improve the service you are able to offer your clients.

What are ImpriMed’s prices?

Please contact [email protected] to request pricing information. We will get back to you within 1 business day.

References

  1. A2LA accreditation. The goal of A2LA’s Veterinary Laboratory Accreditation Program is to promote the health of both privately- and commercially-owned animals through the accreditation of veterinary and animal drug testing laboratories. This program was developed to evaluate diagnostic and clinical veterinary laboratories that conduct veterinary testing.
  2. Zandvliet M. Canine lymphoma: a review. Vet Q. 2016 Jun;36(2):76-104. doi: 10.1080/01652176.2016.1152633. Epub 2016 Mar 8. PMID: 26953614.
  3. Thalheim L, Williams LE, Borst LB, Fogle JE, Suter SE. Lymphoma immunophenotype of dogs determined by immunohistochemistry, flow cytometry, and polymerase chain reaction for antigen receptor rearrangements. J Vet Intern Med. 2013 Nov-Dec;27(6):1509-16. doi: 10.1111/jvim.12185. Epub 2013 Sep 20. PMID: 24112291.