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Published on: November 3, 2018
Flow cytometric immunophenotypic analysis of 306 cases of multiple myeloma
Pei Lin1, Rebecca Owens, Guido Tricot
1Department of Pathology and Laboratory Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Insights
Flow cytometric immunophenotyping of plasma cells (PCs) in multiple myeloma revealed distinct antigen expression patterns. This analysis aids in identifying minimal residual disease and guiding targeted therapy selection for myeloma patients.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Multiple myeloma is a cancer of plasma cells.
- Accurate immunophenotyping of plasma cells is crucial for diagnosis and treatment monitoring.
Purpose of the Study:
- To characterize the immunophenotypic profile of plasma cells in multiple myeloma using flow cytometry.
- To evaluate the utility of specific antigen expression for distinguishing myeloma from other B-cell malignancies and for detecting minimal residual disease.
Main Methods:
- Analysis of bone marrow aspirates from 306 multiple myeloma patients via flow cytometric immunophenotyping.
- Identification of plasma cells using CD138, CD38, and CD45, with monoclonality confirmed by immunoglobulin light chain analysis.
- Determination of immunophenotypic profiles using a panel of antibodies, including CD56, CD117, CD20, CD45, CD52, and CD19.
Main Results:
- Moderate to bright expression of CD56 (71.7%), CD117 (17.8%), CD20 (9.3%), CD45 (8.8%), and CD52 (5.2%) was detected in plasma cells.
- CD19 was negative in over 99% of cases.
- The combination of CD38 and CD138 improved identification of CD45+ myeloma and differentiation from B-cell lymphoma.
Conclusions:
- Plasma cell immunophenotyping provides a detailed profile of antigen expression in multiple myeloma.
- Aberrant antigen expression can aid in minimal residual disease detection.
- Immunophenotypic data may inform the selection of targeted therapeutic agents for multiple myeloma.
Abstract:
Bone marrow aspirates from 306 patients with multiple myeloma were analyzed by flow cytometric immunophenotyping. The plasma cells (PCs) were identified by their characteristic light scatter distribution and reactivity patterns to CD138, CD38, and CD45. Monoclonality was confirmed by immunoglobulin light chain analysis. The immunophenotypic profile of the PCs was determined with a panel of antibodies. Moderate to bright expression of CD56, CD117, CD20, CD45, and CD52 was detected in 71.7%, 17.8%, 9.3%, 8.8%, and 5.2% of cases, respectively. These antigens were expressed by a distinct subpopulation of the PCs in 6.3%, 2.2%, 3.7%, 2.9%, and 2.6% of additional cases. CD19 was negative in more than 99% of cases. The combination of CD38 and CD138 was superior to CD38 alone for identifying CD45+ myeloma and separating CD20+ myeloma from B-cell lymphoma. PC immunophenotyping might be useful for detecting minimal residual disease in cases with aberrant antigen expression and for selection of therapeutic agents that have specific membrane targets.
