title: Immunophenotypic characterization and quantification of neoplastic bone marrow plasma cells by multiparametric flow cytometry and its clinical significance in Korean myeloma patients.
abstract: Multiparametric flow cytometry (MFC) allows discrimination between normal and neoplastic plasma cells (NeoPCs) within the bone marrow plasma cell (BMPC) compartment. This study sought to characterize immunophenotypes and quantitate the proportion of NeoPCs in BMPCs to diagnose plasma cell myeoma (PCM) and evaluate the prognostic impact of this method. We analyzed the MFC data of the bone marrow aspirates of 76 patients with PCM and 33 patients with reactive plasmacytosis. MFC analysis was performed using three combinations: CD38/CD138/-/CD45; CD56/CD20/CD138/CD19; and CD27/CD28/CD138/CD117. The plasma cells of patients with reactive plasmacytosis demonstrated normal immunophenotypic patterns. Aberrant marker expression was observed in NeoPCs, with negative CD19 expression observed in 100% of cases, CD56+ in 73.7%, CD117+ in 15.2%, CD27- in 10.5%, CD20+ in 9.2%, and CD28+ in 1.3%. In PCM patients, more than 20% of NeoPCs/BMPCs were significantly associated with factors suggestive of poor clinical outcomes. Patients who were CD27- or CD56+/CD27-, demonstrated shorter overall survival than patients of other CD56/CD27 combinations. Our results support the clinical value of immunophenotyping and quantifying NeoPCs in PCM patients. This strategy could help to reveal poor prognostic categories and delineate surrogate markers for risk stratification in PCM patients.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan, College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Young-Uk
authors.initials: YU
authors.lastname: Cho
authors.forename: Chan-Jeoung
authors.initials: CJ
authors.lastname: Park
authors.forename: Seo-Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Chi
authors.forename: Seongsoo
authors.initials: S
authors.lastname: Jang
authors.forename: Sang Hyuk
authors.initials: SH
authors.lastname: Park
authors.forename: Eul-Ju
authors.initials: EJ
authors.lastname: Seo
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001854:Bone Marrow Cells / Q000166:cytology* / Q000378:metabolism; D019002:CD56 Antigen / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000166:cytology* / Q000378:metabolism; D011379:Prognosis; D056910:Republic of Korea; D012307:Risk Factors; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000378:metabolism
chemical_list: D019002:CD56 Antigen; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7
keywords: Flow Cytometry; Immunophenotyping; Multiple Myeloma; Neoplastic Cells; Plasma Cells