Gressier Mélanie, Chaquin Michael, Lhermitte Ludovic, Asnafi Vahid, Macintyre Elizabeth, Brouzes Chantal
Laboratoire d'hématologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris AP-HP, Paris, France.
Ann Biol Clin (Paris). 2013 May-Jun;71(3):313-23. doi: 10.1684/abc.2013.0813.
Bone marrow flow cytometric analysis is a powerful and rapid tool for evaluating aberrant plasma cell. In this study, we have examined the utility of multiparameter flow cytometry (MFC) in 52 patients with multiple myeloma (MM) and in 45 patients with monoclonal gammopathy with unknown significance (MGUS) into routine evaluation for the management of patients with plasma cell-related disorders. The plasma cells (PC) were identified by their light scatter distribution and reactivity patterns to CD138, CD38, and CD45. The combination of these parameters was helpful for identifying distinct subpopulations of PCs. Moderate to bright expression of CD56, CD20, CD24, CD28, and CD117 was detected in 67%, 26%, 13%, 27%, and 57% of MM cases and in 58%, 20%, 11%, 43% and 44% of MGUS cases, respectively. In MGUS group, the median percentage abnormal PCs/total PCs was 88% with 37 patients out of 45 (82%) with ratio <95%. The median ratio of the MM group was 98.9% and a ratio ≥ 95% was observed in 37 samples out of 44 (84%). In conclusion, MFC immunophenotyping of PCs has obvious clinical relevance in differential diagnosis between MM and others monoclonal gammopathies, identification of high-risk MGUS and smouldering MM, and minimal residual disease monitoring of MM. Our results showed that this tool can be easily applied in haematology laboratories.
骨髓流式细胞术分析是评估异常浆细胞的一种强大且快速的工具。在本研究中，我们检测了多参数流式细胞术（MFC）在52例多发性骨髓瘤（MM）患者和45例意义未明的单克隆丙种球蛋白病（MGUS）患者中用于浆细胞相关疾病患者常规评估的效用。通过浆细胞（PC）的光散射分布以及对CD138、CD38和CD45的反应模式来识别它们。这些参数的组合有助于识别不同的PC亚群。在MM病例中，分别有67%、26%、13%、27%和57%检测到CD56、CD20、CD24、CD28和CD117呈中度至明亮表达；在MGUS病例中，上述指标分别为58%、20%、11%、43%和44%。在MGUS组中，异常PC/总PC的中位数百分比为88%，45例患者中有37例（82%）该比例<95%。MM组的中位数比例为98.9%，44个样本中有37个（84%）观察到该比例≥95%。总之，PC的MFC免疫表型分析在MM与其他单克隆丙种球蛋白病的鉴别诊断、高危MGUS和冒烟型MM的识别以及MM的微小残留病监测方面具有明显的临床相关性。我们的结果表明，该工具可轻松应用于血液学实验室。
