Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders.
The European Myeloma Network (EMN) organized two flow cytometry workshops. The first aimed to identify specific indications for flow cytometry in patients with monoclonal gammopathies, and consensus technical approaches through a questionnaire-based review of current practice in participating laboratories. The second aimed to resolve outstanding technical issues and develop a consensus approach to analysis of plasma cells. The primary clinical applications identified were: differential diagnosis of neoplastic plasma cell disorders from reactive plasmacytosis; identifying risk of progression in patients with MGUS and detecting minimal residual disease. A range of technical recommendations were identified, including: 1) CD38, CD138 and CD45 should all be included in at least one tube for plasma cell identification and enumeration. The primary gate should be based on CD38 vs. CD138 expression; 2) after treatment, clonality assessment is only likely to be informative when combined with immunophenotype to detect abnormal cells. Flow cytometry is suitable for demonstrating a stringent complete remission; 3) for detection of abnormal plasma cells, a minimal panel should include CD19 and CD56. A preferred panel would also include CD20, CD117, CD28 and CD27; 4) discrepancies between the percentage of plasma cells detected by flow cytometry and morphology are primarily related to sample quality and it is, therefore, important to determine that marrow elements are present in follow-up samples, particularly normal plasma cells in MRD negative cases.
Rawstron
Andy C
AC
HMDS, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Orfao
Alberto
A
Beksac
Meral
M
Bezdickova
Ludmila
L
Brooimans
Rik A
RA
Bumbea
Horia
H
Dalva
Klara
K
Fuhler
Gwenny
G
Gratama
Jan
J
Hose
Dirk
D
Kovarova
Lucie
L
Lioznov
Michael
M
Mateo
Gema
G
Morilla
Ricardo
R
Mylin
Anne K
AK
Omedé
Paola
P
Pellat-Deceunynck
Catherine
C
Perez Andres
Martin
M
Petrucci
Maria
M
Ruggeri
Marina
M
Rymkiewicz
Grzegorz
G
Schmitz
Alexander
A
Schreder
Martin
M
Seynaeve
Carine
C
Spacek
Martin
M
de Tute
Ruth M
RM
Van Valckenborgh
Els
E
Weston-Bell
Nicky
N
Owen
Roger G
RG
San Miguel
Jesús F
JF
Sonneveld
Pieter
P
Johnsen
Hans E
HE
D000911:Antibodies, Monoclonal / Q000276:immunology; D015703:Antigens, CD / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D002452:Cell Count / Q000295:instrumentation / Q000379:methods; D002869:Chromosome Aberrations; D003937:Diagnosis, Differential; D005434:Flow Cytometry / Q000379:methods* / Q000592:standards; D006801:Humans; D016130:Immunophenotyping / Q000379:methods / Q000592:standards; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D018365:Neoplasm, Residual; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D010950:Plasma Cells / Q000737:chemistry / Q000473:pathology; D011379:Prognosis; D012074:Remission Induction
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D014408:Biomarkers, Tumor