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Utility of flow cytometry immunophenotyping in multiple myeloma and other clonal plasma cell-related disorders
Bruno Paiva1, Julia Almeida, Martin Pérez-Andrés
1Department of Medicine, Services of Cytometry and Hematology and Cancer Research Center (CIC, IBMCC USAL-CSIC), University of Salamanca and University Hospital of Salamanca, Salamanca, Spain.
Insights
Multiparameter flow cytometry (MFC) is crucial for diagnosing and monitoring plasma cell disorders like multiple myeloma. Routine use of MFC aids in differential diagnosis, risk stratification, and minimal residual disease assessment.
Area of Science:
- Hematology
- Clinical Immunology
- Oncology
Background:
- Multiparameter flow cytometry (MFC) is standard for hematological malignancy management.
- Its application in plasma cell (PC) disorders, including multiple myeloma (MM), is not yet routine in many labs.
- PC disorders require standardized diagnostic and monitoring tools.
Purpose of the Study:
- To review the clinical utility of MFC in evaluating PC disorders.
- To emphasize areas where MFC integration into routine care for MM and related disorders is needed.
- To highlight the diagnostic and prognostic value of MFC in PC dyscrasias.
Main Methods:
- Review of current clinical applications of MFC in PC disorders.
- Emphasis on consensus areas for routine MFC implementation.
- Discussion of MFC's role in diagnosis, risk stratification, and therapy monitoring.
Main Results:
- MFC is clinically relevant for differentiating MM from other PC disorders.
- MFC aids in identifying high-risk monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM.
- MFC is valuable for minimal residual disease assessment post-therapy and defining prognostic profiles.
Conclusions:
- MFC has established clinical relevance in the management of clonal PC disorders.
- Routine incorporation of MFC is recommended for accurate diagnosis, risk assessment, and monitoring of MM and related conditions.
- MFC offers potential for identifying novel therapeutic targets in PC disorders.
Abstract:
In recent years, multiparameter flow cytometry (MFC) immunophenotyping has become mandatory in the clinical management of hematological malignancies, both for diagnostic and monitoring purposes. Multiple myeloma (MM) and other clonal plasma cell-related (PC) disorders should be no exception to this paradigm, but incorporation of immunophenotypic studies in the management of patients with PC disorders is still far from being routinely established in many diagnostic flow cytometry laboratories. For clonal PC disorders, MFC is of clear and established clinical relevance in: (1) the differential diagnosis between MM and other PC-related disorders; (2) the identification of high-risk MGUS and smoldering MM; (3) minimal residual disease investigation after therapy; additionally it may also be useful for (4) the definition of prognosis-associated antigenic profiles; and (5) the identification of new therapeutic targets. In this article, we review the clinical value of MFC in the study of PC disorders, with specific emphasis in those areas where consensus exists on the need to incorporate MFC into routine evaluation of MM and other clonal PC-related disorders.
