Chen H, Zeng B B, Zhao Y, Xie Y, Jin M L
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China.
Zhonghua Bing Li Xue Za Zhi. 2020 Nov 8;49(11):1136-1141. doi: 10.3760/cma.j.cn112151-20200306-00178.
To investigate the relationship between six common cytogenetic abnormalities and bone marrow pathomorphology in multiple myeloma (MM). Bone marrow biopsy was performed on 151 newly-diagnosed MM patients. Meanwhile, myeloma cells were enriched by CD138 immunomagnetic beads, and then lq+, 13q-, 17p-, t(4;14), t (11;14), t (14;16) and other common genetic abnormalities were detected using interphase fluorescence in situ hybridization (FISH). The relationship between different genetic abnormalities and biopsy morphology was compared. Of the 151 patients, 15 had extramedullary infiltration (9.9%). The rate of cytogenetic abnormalities was 76.2% (115/151), of which 1q+ accounted for 49.7% (75/151), 13q-39.1% (59/151), 17p-8.6% (13/151), t(4;14) 21.2% (32/151), t(11;14) 19.2% (29/151), and t(14;16) 2.0% (3/151). The proliferation patterns of MM plasma cells were nodular (48.3%, 73/151), interstitial (33.8%, 51/151) and diffuse (17.9%, 27/151). The morphology of plasma cells was mainly mature type (58.3%, 88/151), followed by juvenile type (20.5%, 31/151), intermediate type (15.9%, 24/151) and plasmacyte type (5.3%, 8/151). According to the mSMART risk stratification system, the proliferation pattern of myeloma cells in the high-risk group was mainly diffuse type, and the morphology was mainly immature and plasmacyte type. In the middle-risk group, mature type myeloma cells were mainly nodular proliferating. In the low-risk and negative group, mature type myeloma cells were mainly interstitial proliferating. There was no difference in the probability of different proliferation modes of intermediate type plasma cells in each group. The proliferation pattern and morphology of plasma cells in bone marrow biopsy combined with cytogenetic markers can more accurately predict the severity and prognosis of MM.
探讨多发性骨髓瘤(MM)中6种常见细胞遗传学异常与骨髓病理形态学之间的关系。对151例新诊断的MM患者进行骨髓活检。同时,采用CD138免疫磁珠富集骨髓瘤细胞,然后运用间期荧光原位杂交(FISH)检测1q+、13q-、17p-、t(4;14)、t(11;14)、t(14;16)等常见基因异常。比较不同基因异常与活检形态之间的关系。151例患者中,15例有髓外浸润(9.9%)。细胞遗传学异常率为76.2%(115/151),其中1q+占49.7%(75/151),13q-占39.1%(59/151),17p-占8.6%(13/151),t(4;14)占21.2%(32/151),t(11;14)占19.2%(29/151),t(14;16)占2.0%(3/151)。MM浆细胞的增殖模式为结节状(48.3%,73/151)、间质状(33.8%,51/151)和弥漫状(17.9%,27/151)。浆细胞形态以成熟型为主(58.3%,88/151),其次为幼稚型(20.5%,31/151)、中间型(15.9%,24/151)和浆细胞样型(5.3%,8/151)。根据mSMART风险分层系统,高危组骨髓瘤细胞增殖模式主要为弥漫型,形态主要为未成熟型和浆细胞样型。中危组成熟型骨髓瘤细胞主要为结节状增殖。低危和阴性组成熟型骨髓瘤细胞主要为间质状增殖。各组中间型浆细胞不同增殖模式的概率无差异。骨髓活检中浆细胞的增殖模式和形态结合细胞遗传学标志物可更准确地预测MM的严重程度和预后。