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Updated: Mar 11, 2026
Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma
Published on: April 15, 2022
Cytoplasmic Immunoglobulin Light Chain Revelation and Interphase Fluorescence In Situ Hybridization in Myeloma
Sarah Moore1, Jeffrey M Suttle2, Mario Nicola2
1Genetics and Molecular Pathology, SA Pathology, Frome Road, Adelaide, South Australia, 5000, Australia. sarah.moore2@sa.gov.au.
Insights
Cytogenetic analysis in plasma cell myeloma (PCM) aids prognosis and treatment planning. Combining karyotyping with cytoplasmic immunoglobulin-FISH (cIg-FISH) improves detection of plasma cell abnormalities, even in small samples.
Area of Science:
- Hematology
- Oncology
- Cytogenetics
Background:
- Plasma cell myeloma (PCM) diagnosis relies on cytogenetic analysis for prognosis and treatment.
- Standard karyotyping can be limited by disease heterogeneity and low plasma cell proliferation.
- Targeted FISH is crucial for detecting cryptic cytogenetic changes in PCM.
Purpose of the Study:
- To present methods for augmenting cytogenetic analysis in PCM.
- To detail the use of cytoplasmic immunoglobulin-FISH (cIg-FISH) for plasma cell identification.
- To provide protocols for cIg-FISH in both fresh and fixed samples.
Main Methods:
- Karyotypic analysis of bone marrow (BM) samples.
- Interphase fluorescence in situ hybridization (FISH) targeting PCM-associated changes.
- Immunofluorescent revelation of cytoplasmic immunoglobulin light chains (cIg-FISH) for plasma cell identification.
Main Results:
- cIg-FISH enables preferential scoring of plasma cells, especially when percentages are low.
- This technique aids in identifying PCM cells within heterogeneous samples.
- cIg-FISH allows separate analysis of non-plasma cells, useful when myeloid disease is suspected.
Conclusions:
- Augmenting karyotyping with cIg-FISH enhances diagnostic accuracy in PCM.
- cIg-FISH is valuable for stratifying PCM patients and guiding therapy.
- Protocols for both fresh and fixed samples ensure broad applicability.
Abstract:
The cytogenetic analysis of plasma cell myeloma (PCM) allows stratification of patients so that prognosis may be determined and appropriate therapeutic options can be discussed. Owing to the patchy nature of the disease in the bone marrow (BM), the low proliferative activity of plasma cells and the cryptic nature of some PCM-associated cytogenetic changes, karyotypic analysis in this disease should be augmented with targeted interphase fluorescence in situ hybridization (FISH). Immunofluorescent revelation of cytoplasmic immunoglobulin light chains, together with interphase FISH (cIg-FISH), allows the identification of plasma cells within a sample so that they may be scored preferentially. This is particularly useful in situations where there are only a small percentage of plasma cells in a sample. Where an underlying myeloid disease is suspected the cIg-FISH-negative cells can be scored separately. Two methods are provided in this chapter: the technique for cIg-FISH in fresh PCM BM samples and a procedure for use in fixed cytogenetics preparations.
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