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Updated: Apr 7, 2026
Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
Clinicopathological features of plasmablastic multiple myeloma: a population-based cohort
Hanne E H Møller1, Birgitte S Preiss1, Per Pedersen2
1Department of Pathology, Odense University Hospital, Odense, Denmark.
Abstract:
Multiple myeloma (MM) is a common malignant hematological disease displaying considerable heterogeneity. Historical data indicate a prognostic significance of plasmablastic morphology, proliferation, and adverse cytogenetics, but there is little knowledge on the degree of interdependency of these parameters. The aim of this study was to study the degree of overlap between these variables. In a consecutive population-based cohort of 194 untreated MM patients, morphology, and proliferation index, using immunohistochemical double staining for Ki-67 and CD138, was analyzed. In addition, cytogenetic changes were studied by karyotyping and fluorescence in situ hybridization (FISH). Plasmablastic morphology correlated with unfavorable clinical features, high proliferation index, high percentage of plasma cell infiltration in the bone marrow, abnormal karyotype, and del(13q) detected by karyotyping, which indicates that plasmablastic morphology reflects advanced and highly proliferative disease. However, plasmablastic morphology did not correlate with established adverse prognostic cytogenetics identified by FISH, for example, t(4;14), t(14;16) and del(17p).
Insights
Plasmablastic morphology in multiple myeloma (MM) indicates advanced, proliferative disease but doesn't correlate with specific adverse cytogenetic markers identified by FISH. This finding clarifies the prognostic significance of morphological features in MM.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Multiple myeloma (MM) is a heterogeneous plasma cell malignancy.
- Prognostic factors like morphology, proliferation, and cytogenetics are known but their interdependencies require further study.
Purpose of the Study:
- To investigate the overlap and interdependency between plasmablastic morphology, proliferation index, and cytogenetic abnormalities in untreated multiple myeloma patients.
Main Methods:
- Analysis of morphology and proliferation index (Ki-67/CD138 staining) in 194 untreated MM patients.
- Cytogenetic analysis using karyotyping and fluorescence in situ hybridization (FISH).
Main Results:
- Plasmablastic morphology correlated with unfavorable clinical features, high proliferation, bone marrow infiltration, and abnormal karyotypes (including del(13q)).
- Plasmablastic morphology did not correlate with specific adverse cytogenetic markers detected by FISH, such as t(4;14), t(14;16), and del(17p).
Conclusions:
- Plasmablastic morphology in MM is indicative of advanced and highly proliferative disease.
- The prognostic value of plasmablastic morphology is distinct from specific adverse cytogenetic alterations identified by FISH.
