多发性骨髓瘤患者骨髓活检和细胞遗传学检查评估。
Assessment of Bone Marrow Biopsy and Cytogenetic Findings in Patients with Multiple Myeloma.
机构信息
Sivas Numune Hospital, Clinic of Hematology, Sivas, Turkey
Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey
出版信息
Turk J Haematol. 2022 Jun 1;39(2):109-116. doi: 10.4274/tjh.galenos.2021.2021.0325. Epub 2021 Nov 26.
OBJECTIVE
Multiple myeloma (MM) is a malignant condition characterized by the accumulation of malignant plasma cells. Although MM remains incurable, the survival of MM patients has improved considerably due to the application of autologous stem cell transplantation, novel agents, and advanced treatment strategies. This study aimed to determine the cytogenetic characterization and bone marrow (BM) features of Turkish patients with MM.
MATERIALS AND METHODS
Eighty-five MM patients were admitted to Dokuz Eylül University Hospital in Turkey. BM samples of these MM patients were subjected to cytogenetic analyses at diagnosis and during therapy as a part of therapeutical and clinical evaluation. A complete cytogenetic study was performed using the G-banding technique. Fluorescence in situ hybridization (FISH) analysis was performed using cytoplasmic immunoglobulin. The degree of BM fibrosis was determined using reticulin histochemical staining. We determined the percentage of BM plasma cells based on the extent of CD38 staining.
RESULTS
Eighty-five MM patients were retrospectively identified between 2015 and 2021. The median age was 63 (38-90) years. Of the 85 patients, 60 (70.6%) were male and 25 (29.4%) were female. Seventy-two (84.7%) cases had BM fibrosis at the time of diagnosis. The most common was grade 2 fibrosis, recorded in 35 cases (41.2%). About 72.9% of the patients showed more than 50% plasma cells. FISH analysis indicated the presence of abnormal chromosomes in 37% (32/85) of the patients. The most frequent abnormality was Immunoglobulin heavy-chain (IGH) translocation (21.3%).
CONCLUSION
Subgroup analysis of IGH mutations is crucial in the identification of high-risk MM patients. We believe that our study will contribute to the determination of BM biopsy and cytogenetic features of MM patients in our country.
目的
多发性骨髓瘤(MM)是一种以恶性浆细胞积累为特征的恶性疾病。尽管 MM 仍然无法治愈,但由于自体干细胞移植、新型药物和先进的治疗策略的应用,MM 患者的生存率有了显著提高。本研究旨在确定土耳其 MM 患者的细胞遗传学特征和骨髓(BM)特征。
材料和方法
85 例 MM 患者被收入土耳其多乌·埃夫大学医院。这些 MM 患者的 BM 样本在诊断时和治疗过程中作为治疗和临床评估的一部分进行细胞遗传学分析。使用 G 带技术进行全面细胞遗传学研究。使用细胞质免疫球蛋白进行荧光原位杂交(FISH)分析。使用网织蛋白组织化学染色确定 BM 纤维化的程度。我们根据 CD38 染色的程度确定 BM 浆细胞的百分比。
结果
2015 年至 2021 年期间,回顾性确定了 85 例 MM 患者。中位年龄为 63 岁(38-90 岁)。85 例患者中,60 例(70.6%)为男性,25 例(29.4%)为女性。72 例(84.7%)患者在诊断时存在 BM 纤维化。最常见的是 2 级纤维化,记录在 35 例(41.2%)。约 72.9%的患者浆细胞比例超过 50%。FISH 分析表明 37%(32/85)的患者存在异常染色体。最常见的异常是免疫球蛋白重链(IGH)易位(21.3%)。
结论
IGH 突变的亚组分析对于确定高危 MM 患者至关重要。我们相信,我们的研究将有助于确定我国 MM 患者的 BM 活检和细胞遗传学特征。