The clinical utility and prognostic value of multiparameter flow cytometry immunophenotyping in light-chain amyloidosis.
The clinical value of multiparameter flow cytometry (MFC) immunophenotyping in primary or light chain amyloidosis (AL) remains unknown. We studied 44 consecutive bone marrow samples from newly diagnosed patients with amyloidosis; 35 patients with AL and 9 with other forms of amyloidosis. Monoclonal plasma cells (PCs) were identifiable by MFC immunophenotyping in 34 of 35 (97%) patients with AL, whereas it was absent from all but 1 of the 9 (11%) patients with other forms of amyloidosis. Quantification of bone marrow plasma cells (BMPCs) by MFC immunophenotyping was a significant prognostic factor for overall survival (OS) (≤ 1% vs > 1% BMPC cutoff; 2-year OS rates of 90% vs 44%, P = .02). Moreover, detecting persistent normal PCs at diagnosis identifies a subgroup of patients with AL with prolonged OS (> 5% vs ≤ 5% normal PC within all BMPC cutoff, 2-year rates of 88% vs 37%, P = .01). MFC immunophenotyping could be clinically useful for the demonstration of PC clonality in AL and for the prognostication of patients with AL.
Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, Salamanca, Spain.
Bruno
B
Paiva
María-Belén
MB
Vídriales
José J
JJ
Pérez
María-Consuelo
MC
López-Berges
Ramón
R
García-Sanz
Enrique M
EM
Ocio
Natalia
N
de Las Heras
Rebeca
R
Cuello
Alfonso
A
García de Coca
Emilia
E
Pardal
José
J
Alonso
Magdalena
M
Sierra
Abelardo
A
Bárez
José
J
Hernández
Lissbett
L
Suárez
Josefina
J
Galende
María-Victoria
MV
Mateos
Jesús F
JF
San Miguel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006331:Heart Diseases / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism*; D016130:Immunophenotyping / Q000379:methods*; D007674:Kidney Diseases / Q000175:diagnosis / Q000378:metabolism; D008107:Liver Diseases / Q000175:diagnosis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis
D007147:Immunoglobulin Light Chains