We present an extreme-throughput (>1 million cells per second) imaging flow cytometer with deep learning to achieve a highly simple, rapid, and cost-effective liquid biopsy for ex-vivo drug-susceptibility testing of leukemia. The drug resistance of leukemia cells was detected in whole blood with only 24-hour drug treatment without hemolysis or dilution, making the sample preparation extremely simple, rapid and cost-effective. Our method also accurately evaluated the drug susceptibility of white blood cells from untreated patients with acute lymphoblastic leukemia, holding great promise for affordable precision medicine.
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