Gupta R, Gupta P, Rahman K, Biswas S, Chandra D, Singh M K, Sarkar M K, Gupta A, Nityanand S
Department of Hematology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India.
Indian J Hematol Blood Transfus. 2022 Jul;38(3):473-480. doi: 10.1007/s12288-021-01477-y. Epub 2021 Aug 10.
Flow cytometric (FCM) immunophenotyping is an important tool for generating diagnostic and prognostic information in plasma cell dyscrasias. This study aimed to evaluate the immunophenotype and ploidy status of plasma cells (PCs) in patients of myeloma and its correlation with other laboratory parameters. Bone marrow of 70 newly diagnosed cases of myeloma were subjected to FCM using a panel of antibodies; CD138, CD38, CD19, CD45, CD28, CD81, CD56, CD200, and CD229. FxCycle Violet (FCV) dye was used for the ploidy analysis of clonal PCs. Median age was 60 years with M:F ratio of 3.2:1. A positive correlation was noted between the morphological and FCM-based PC enumeration (r = 0.4, = 0.001). Aberrant expression of CD56, CD200, CD28, CD117, CD81 and CD19 and was observed in 88.5%, 77%, 29%, 37%, 23% and 17% cases respectively. Two aberrant antigens were noted in all cases. CD81 + cases had a relatively higher quantity of monoclonal-protein (> 1 g/dl, < 0.05) and renal insufficiency (Cr > 2 mg/dl, < 0.05) as compared to the CD81- cases. CD229 was expressed in all the cases, with a median MFI in PCs significantly higher than other hematopoietic elements. Hyperdiploid PCs (median DI-1.59, range, 1.16-2.6) were noted in 80% cases (n = 48), diploid/ near-hyperdiploid PCs in 8% (n = 5) cases and hypodiploidy in 3% (n = 1) cases. Bright CD56/CD200 and CD45- can identify abnormal PC in the majority of the cases. CD81 appears to correlate with disease burden and might be useful as a prognostic marker. CD229 is a reliable gating marker for plasma cells. Ploidy analysis may be incorporated in routine workup to guide in the identification of patients with poor prognosis.
The online version contains supplementary material available at 10.1007/s12288-021-01477-y.
流式细胞术（FCM）免疫表型分析是生成浆细胞发育异常诊断和预后信息的重要工具。本研究旨在评估骨髓瘤患者浆细胞（PC）的免疫表型和倍体状态及其与其他实验室参数的相关性。使用一组抗体（CD138、CD38、CD19、CD45、CD28、CD81、CD56、CD200和CD229）对70例新诊断的骨髓瘤病例的骨髓进行FCM检测。FxCycle Violet（FCV）染料用于克隆性PC的倍体分析。中位年龄为60岁，男女比例为3.2:1。形态学和基于FCM的PC计数之间存在正相关（r = 0.4，P = 0.001）。CD56、CD200、CD28、CD117、CD81和CD19的异常表达分别在88.5%、77%、29%、37%、23%和17%的病例中观察到。所有病例均发现两种异常抗原。与CD81阴性病例相比，CD81阳性病例的单克隆蛋白量相对较高（>1 g/dl，P<0.05）且肾功能不全（Cr>2 mg/dl，P<0.05）。所有病例均表达CD229，PC中的中位平均荧光强度（MFI）显著高于其他造血细胞成分。80%（n = 48）的病例中观察到超二倍体PC（中位DI - 1.59，范围1.16 - 2.6），8%（n = 5）的病例中为二倍体/近超二倍体PC，3%（n = 1）的病例中为亚二倍体。明亮的CD56/CD200和CD45阴性可在大多数病例中识别异常PC。CD81似乎与疾病负担相关，可能作为预后标志物。CD229是浆细胞可靠的门控标志物。倍体分析可纳入常规检查以指导识别预后不良的患者。
在线版本包含可在10.1007/s12288 - 021 - 01477 - y获取的补充材料。
