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EuroFlow External Quality Assessment Program

The EuroFlow Consortium has established fully standardized methods for flow cytometry consisting of standardized instrument settings, reagent panels, sample preparation protocols, and software for data analysis and disease classification. The software tools enable large-scale data analysis and a direct comparison of individual cases against reference datasets composed of specific disease categories. The need for comparability of antigen expression measured in different centers calls for quality assessment to ensure that the high level of standardization is maintained in all participating centers. This also improves the reliability of the EuroFlow reference data. Therefore, EuroFlow developed innovative and easy to implement external quality assessment (EQA) schemes that aim at monitoring flow cytometric processes (cytometer settings, sample preparation, data acquisition, and/or data analysis and interpretation) and supporting laboratories in implementing the EuroFlow protocols to the highest standard. The EuroFlow EQA program is meant to complement, but not to replace other established proficiency tests. The EuroFlow EQA program is organized by ESLHO in collaboration with members from the EuroFlow Consortium.

EQA for EuroFlow Protocols

The EQA schemes of EuroFlow are proficiency tests for laboratories that follow the EuroFlow protocols. The participants should routinely use the EuroFlow Lymphoid Screening Tube (LST), Multiple Myeloma (MM) MRD tube, Primary Immunodeficiency Orientation Tube (PIDOT), and/or the B Cell Precursor-Acute Lymphoblastic Leukemia (BCP-ALL) MRD tube. Participants in the EuroFlow EQA program use local healthy donor samples and therefore no sample shipment is necessary.

EuroFlow offers four different EQA schemes:

The Lymphoid Screening Tube (LST) EQA scheme

This scheme is designed to mimic the routine sample preparation and data acquisition. For each LST round, peripheral blood samples obtained locally from three healthy donors are processed according to the EuroFlow method. The participant’s results are then compared with the reference data and to the results from other participants on the round. Deviations from the reference values are quantified using performance score metrics and the results are summarized in a certificate.

The Multiple Myeloma (MM) Measurable Residual Disease (MRD) EQA scheme

The EuroFlow Next Generation Flow (NGF) Multiple Myeloma (MM) Measurable Residual Disease (MRD) scheme is designed to provide an external control for multiparametric flow cytometry detection of MRD in MM patients after therapy. For each MM MRD round, three FCS files are provided to the participants. These FCS files represent bone marrow samples from MM patients after treatment, processed following the NGF methodology. Participants analyze each file and report their conclusions. Participant performance is then compared to the reference values and to the results from other participants in the round.

The Primary Immunodeficiency Orientation Tube (PIDOT) EQA scheme

This scheme is designed to provide an external control for multiparametric flow cytometry screening for primary immunodeficiencies. It is divided into two parts, a ‘wet lab´ part, which is designed similarly to the LST scheme and a ‘dry’ part, in which participants are provided with two FCS files prepared from patients with immunodeficiency. Participants analyze these files and report their conclusions. Participant performance is then compared to the reference values and to the results from other participants in the round.

The B Cell Precursor-ALL Measurable Residual Disease (BCP-ALL MRD) EQA scheme

This scheme combines a ‘wet lab´ part, which is similar to the LST scheme, and a ‘dry’ part, which uses files from BCP-ALL patients. Participants merge these files with the control files obtained in the ‘wet lab´ part and analyze them together. This requires software that enables merging of the files (e.g. Infinicyt). Participant performance is then compared to the reference values and to the results from other participants in the round.

Feedback

After each EQA round, participants will be provided with a personalized certificate in which they can clearly see how their results compare to the reference values, but also how they performed in relation to the other participating laboratories. Participants are also provided with tips on how to improve. The EuroFlow EQA schemes are concluded by a EuroFlow EQA Educational meeting, which is organized once a year. During the meeting, possible problems and pitfalls will be discussed and participants will have the opportunity to ask questions.

Structure

The EuroFlow EQA program is organized by ESLHO in collaboration with members of the EuroFlow Consortium, including the following lead subject-matter experts:

  • Prof. Dr. Tomas Kalina (Lead expert for LST scheme; Charles University, Prague, CZ)
  • Dr. Juan Flores-Montero (Lead expert for MM MRD scheme; University of Salamanca, Salamanca, ES).
  • Prof. Dr. Carolien Bonroy (Lead expert for PIDOT scheme; University of Ghent, Ghent, BE)
  • Dr. Michaela Reiterova (Lead expert for BCP-ALL MRD scheme; Charles University, Prague, CZ),

The EuroFlow EQA program is organized twice a year. Participants may choose the EQA schemes according to their needs and interests.

EuroFlow EQA 2026

Subscription options:

Participation in one round of any EQA scheme: € 270,-
Participation in both rounds of one EQA scheme: € 490,-

For each additional certificate in the LST EQA scheme (e.g. for additional instruments) there will be an extra charge of € 110,-. Other schemes do not have the option of multiple reports.

Round I schedule:

Registration for all schemes: 5 – 30 January 2026 (registration for both spring and autumn rounds will be possible during this period)

LST and MM MRD:

Reporting of results: 2 – 27 February 2026
Certificates issued: May 2026

PIDOT and BCP-ALL MRD:

Reporting of results: 2 – 27 March 2026
Certificates issued: June – July 2026

Round II schedule:

Registration for all schemes: 1 June – 28 August 2026 (registration for the autumn round will be possible during this period)

LST and MM MRD:
Reporting of results through the website: 31 August – 25 September 2026
Certificates issued: January 2027

PIDOT and BCP-ALL MRD:
Reporting of results through the website: 28 September – 23 October 2026
Certificates issued: January 2027

For more information and/or to register for the EuroFlow EQA program, please go to https://eqa.eslho.org/