Enhancing detection of central nervous system involvement in multiple myeloma: A novel multidimensional dot-plot...

Area of Science:

• Hematology
• Oncology
• Neuroscience
• Immunology

Background:

• Central nervous system (CNS) involvement in multiple myeloma (MM) is a rare but severe complication.
• Early diagnosis of CNS involvement relies on identifying malignant plasma cells in cerebrospinal fluid (CSF).
• Traditional methods like cytology have low sensitivity, particularly in low-cell-count CSF samples.

Purpose of the Study:

• To develop and evaluate a multidimensional radar dot-plot analysis using Kaluza software.
• To enhance the sensitivity and specificity of flow cytometry for detecting abnormal plasma cells in CSF.
• To improve the diagnosis of CNS involvement in multiple myeloma (MM).

Main Methods:

• Multicolor flow cytometry (8-color labeling) was performed on 89 CSF samples from 40 patients.
• A novel radar dot-plot analysis was developed using Kaluza software to differentiate cell types.
• Sensitivity was tested using diluted myeloma bone marrow cells in pooled CSF to simulate low cell counts.

Main Results:

• The multidimensional radar dot-plot analysis demonstrated superior performance compared to conventional 2D analysis.
• The novel method identified abnormal plasma cells in samples with cell counts as low as <1 cell/μL.
• Discordant results in 32% of samples were resolved by multidimensional analysis, reducing false positives.

Conclusions:

• The radar dot-plot analysis significantly increases the sensitivity and specificity of flow cytometry for MM CNS involvement detection.
• This method is effective even in low-cell-count CSF samples and is compatible with different sample storage tubes.
• The approach offers a reliable tool for improved diagnostic accuracy in assessing neurological complications of MM.