title: Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders.
abstract: 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.
authors.affiliation: HMDS, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Andy C
authors.initials: AC
authors.lastname: Rawstron
authors.forename: Alberto
authors.initials: A
authors.lastname: Orfao
authors.forename: Meral
authors.initials: M
authors.lastname: Beksac
authors.forename: Ludmila
authors.initials: L
authors.lastname: Bezdickova
authors.forename: Rik A
authors.initials: RA
authors.lastname: Brooimans
authors.forename: Horia
authors.initials: H
authors.lastname: Bumbea
authors.forename: Klara
authors.initials: K
authors.lastname: Dalva
authors.forename: Gwenny
authors.initials: G
authors.lastname: Fuhler
authors.forename: Jan
authors.initials: J
authors.lastname: Gratama
authors.forename: Dirk
authors.initials: D
authors.lastname: Hose
authors.forename: Lucie
authors.initials: L
authors.lastname: Kovarova
authors.forename: Michael
authors.initials: M
authors.lastname: Lioznov
authors.forename: Gema
authors.initials: G
authors.lastname: Mateo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Morilla
authors.forename: Anne K
authors.initials: AK
authors.lastname: Mylin
authors.forename: Paola
authors.initials: P
authors.lastname: Omedé
authors.forename: Catherine
authors.initials: C
authors.lastname: Pellat-Deceunynck
authors.forename: Martin
authors.initials: M
authors.lastname: Perez Andres
authors.forename: Maria
authors.initials: M
authors.lastname: Petrucci
authors.forename: Marina
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Rymkiewicz
authors.forename: Alexander
authors.initials: A
authors.lastname: Schmitz
authors.forename: Martin
authors.initials: M
authors.lastname: Schreder
authors.forename: Carine
authors.initials: C
authors.lastname: Seynaeve
authors.forename: Martin
authors.initials: M
authors.lastname: Spacek
authors.forename: Ruth M
authors.initials: RM
authors.lastname: de Tute
authors.forename: Els
authors.initials: E
authors.lastname: Van Valckenborgh
authors.forename: Nicky
authors.initials: N
authors.lastname: Weston-Bell
authors.forename: Roger G
authors.initials: RG
authors.lastname: Owen
authors.forename: Jesús F
authors.initials: JF
authors.lastname: San Miguel
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Hans E
authors.initials: HE
authors.lastname: Johnsen
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D014408:Biomarkers, Tumor