Clinical investigation laboratory, Department of Medical science, Maggiore Hospital, Asst-Crema.
Oncology Unit, Department of Medical science, Maggiore Hospital, Asst-Crema.
Recenti Prog Med. 2024 May;115(5):238-242. doi: 10.1701/4262.42403.
Plasma cell multiple myeloma (MM) is a multiform clinical entity characterized by different laboratory hallmarks. This case shows a rare entity of plasma cell myeloma: the entire plasma cell population lack the CD138 expression. In this case, a careful analysis of laboratory finding, particular flow cytometry gating strategies and the use of other ancillary laboratory tests, guide the clinicians to correct diagnosis. The correct evaluation of pre-analytical phase and the correct gating strategy are the necessary conditions to produce robust and solid flow cytometric results. The diagnostic implications of CD138-negative plasma cell are strictly linked to stem cell-like clonogenic features, such as possible more aggressive clinical behaviour and increasing probability of chemotherapy resistance. At this time, clinical laboratory remains the main reference point to MM diagnosis.
浆细胞多发性骨髓瘤（MM）是一种多形态的临床实体，其特征是具有不同的实验室特征。本病例显示了浆细胞骨髓瘤的一种罕见实体：整个浆细胞群缺乏 CD138 表达。在这种情况下，对实验室发现的仔细分析，特别是流式细胞术门控策略的应用和其他辅助实验室检查，指导临床医生做出正确的诊断。对分析前阶段的正确评估和正确的门控策略是产生强大而可靠的流式细胞术结果的必要条件。CD138 阴性浆细胞的诊断意义与干细胞样克隆特征密切相关，例如可能具有更具侵袭性的临床行为和增加化疗耐药的可能性。目前，临床实验室仍然是 MM 诊断的主要参考点。
