title: Irregular nuclear shape of bone marrow plasma cells defines a multiple myeloma subgroup related to hypodiploidy and to short survival.
abstract: Morphological changes of plasma cells (PC) are common in multiple myeloma (MM). Loss of round or oval nuclear shape has been related to cell malignancy in human, and we looked for the occurrence of such morphological change on PC from bone marrow (BM) smears in a retrospective series of 169 MM patients at diagnosis. Nuclear shape changes of PC differed according to the patients (notch, dumb-bell, folded or monocytoid appearance), even in the same patient; all subtypes were pooled and defined as PC with irregular nuclear shape (PCIN). A significant number of PCIN (>/=5% of all BMPC) was found at diagnosis in 20.7%. Median survival was of 22 months for patients with >/=5% PCIN, and 41 months for others (p=0.0001). Significant relationship was observed with prognostic parameters related intrinsic malignancy of the tumour process but not with beta-2-microglobulin (b2m). A clear-cut relationship was found also between PCIN and hypodiploidy (p=0.0001), but not with deletion of chromosome 13. This study emphasises the relationship between PCIN, an easy-to-ascertain marker of intrinsic malignancy of the tumour process, and adverse prognosis.
authors.affiliation: Service des Maladies du Sang, CHU Lille, France. xavier_leleu@dfci.harvard.edu
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.forename: Franck
authors.initials: F
authors.lastname: Genevieve
authors.forename: Romain
authors.initials: R
authors.lastname: Guieze
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Joris
authors.initials: J
authors.lastname: Andrieux
authors.forename: Celine
authors.initials: C
authors.lastname: Berthon
authors.forename: Alban
authors.initials: A
authors.lastname: Godon
authors.forename: Sophie
authors.initials: S
authors.lastname: Prat-Lesaffre
authors.forename: Stephane
authors.initials: S
authors.lastname: Depil
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Lai
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Marc
authors.initials: M
authors.lastname: Zandecki
mesh_terms: D000368:Aged; D000782:Aneuploidy; D001854:Bone Marrow Cells / Q000473:pathology* / Q000648:ultrastructure; D002467:Cell Nucleus / Q000473:pathology / Q000648:ultrastructure*; D020732:Cytogenetic Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis