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Ring neutrophils in plasma cell dyscrasia
1Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.
Abstract:
Sporadic reports in the medical literature concern the significant incidence of neutrophils with ring-shaped nuclei in myeloproliferative disorders. We report our first encounter with ring neutrophils in patients with lymphoproliferative disorders. A significant incidence of ring neutrophils was observed in all of 20 patients with multiple myeloma and in nine of 10 patients with monoclonal gammopathy of undetermined significance. The mean percent of ring neutrophils was 9.5% (range, 1.0% to 28.0%) in patients with multiple myeloma, which was significantly greater than in those with monoclonal gammopathy of undetermined significance or in healthy controls. In multiple myeloma, the incidence of ring neutrophils in the pretreatment phase was greater than that in the remission phase. A great deal of overlap was noted between multiple myeloma in the remission phase and monoclonal gammopathy of undetermined significance. The incidence of ring neutrophils seemed to vary according to disease stage. Ring neutrophils may reflect abnormal granulopoiesis in plasma cell dyscrasias.
Insights
Ring neutrophils, characterized by ring-shaped nuclei, are found in lymphoproliferative disorders. Their incidence is higher in multiple myeloma patients, potentially indicating abnormal granulopoiesis in plasma cell dyscrasias.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Neutrophils with ring-shaped nuclei have been sporadically reported in myeloproliferative disorders.
- Their presence in lymphoproliferative disorders is less documented.
Purpose of the Study:
- To investigate the incidence and significance of ring neutrophils in plasma cell dyscrasias, specifically multiple myeloma and monoclonal gammopathy of undetermined significance.
- To compare ring neutrophil counts between these conditions and healthy controls.
Main Methods:
- Observational study analyzing peripheral blood smears from patients diagnosed with multiple myeloma and monoclonal gammopathy of undetermined significance.
- Comparison of ring neutrophil percentages between patient groups and a control group of healthy individuals.
Main Results:
- A high incidence of ring neutrophils was observed in all 20 multiple myeloma patients and 9 of 10 patients with monoclonal gammopathy of undetermined significance.
- The mean percentage of ring neutrophils was significantly higher in multiple myeloma (9.5%) compared to monoclonal gammopathy of undetermined significance and healthy controls.
- Ring neutrophil incidence was greater in the pretreatment phase of multiple myeloma than in remission, with overlap between remission and monoclonal gammopathy of undetermined significance.
Conclusions:
- Ring neutrophils are a notable finding in plasma cell dyscrasias, particularly multiple myeloma.
- The incidence of ring neutrophils may serve as a biomarker reflecting abnormal granulopoiesis and disease activity in these hematologic malignancies.