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Related Experiment Videos

Circulating monotypic B-cells in multiple myeloma: association with lambda paraproteins.

A Bagg1, P Becker, W Bezwoda

  • 1Haematology Department, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.

British Journal of Haematology
|June 1, 1989
PubMed
Summary

Monotypic B-cells (MBCs) are more common in the peripheral blood of multiple myeloma patients with lambda paraproteins than kappa. This finding in plasma cell dyscrasias may indicate a worse prognosis for lambda-producing patients.

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Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Plasma cell dyscrasias, including multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS), are characterized by the proliferation of abnormal plasma cells.
  • The immunophenotype of peripheral blood and bone marrow cells can provide insights into disease characteristics and prognosis.

Purpose of the Study:

  • To investigate the relationship between peripheral blood monotypic B-cells (MBCs) and paraprotein light chain isotype in patients with plasma cell dyscrasias.
  • To compare the sensitivity of peripheral blood immunophenotyping with other methods for detecting disease involvement.

Main Methods:

  • Analysis of peripheral blood and bone marrow mononuclear cell immunophenotypes in 41 patients with plasma cell dyscrasias (29 MM, 12 MGUS/solitary plasmacytoma).

Related Experiment Videos

  • Statistical analysis to determine the relationship between MBC presence and paraprotein light chain isotype (kappa vs. lambda).
  • Comparison of immunophenotyping sensitivity with karyotype and immunoglobulin gene rearrangement investigations.

    • Main Results:

    • A statistically significant association was found between MBC presence in peripheral blood and lambda paraproteins in myeloma patients (P = 0.0025).
    • MBCs were detected in 71% of lambda-producing patients versus 13% of kappa-producing patients.
    • Higher calcium levels were observed in lambda producers; a similar trend for MBCs was noted in lambda-producing MGUS/solitary plasmacytoma patients.
    • Peripheral blood immunophenotyping demonstrated higher sensitivity than karyotype or immunoglobulin gene rearrangements.

    Conclusions:

    • The presence of MBCs in peripheral blood is significantly associated with lambda paraproteins in plasma cell dyscrasias.
    • This association may contribute to the poorer prognosis observed in patients with lambda paraproteins.
    • Immunophenotypic detection of peripheral blood involvement is a sensitive method for diagnosing plasma cell dyscrasias.