title: Plasma cell enrichment enhances detection of high-risk cytogenomic abnormalities by fluorescence in situ hybridization and improves risk stratification of patients with plasma cell neoplasms.
abstract: BACKGROUND
  Methods for plasma cell enrichment of bone marrow (BM) specimens can increase the sensitivity of fluorescence in situ hybridization (FISH) for detecting cytogenomic abnormalities. There are no published reports using these methods to evaluate high-risk cytogenomic abnormalities in patients with plasma cell neoplasms (PCNs) after therapy.
  
  
  OBJECTIVE
  To evaluate the utility of plasma cell enrichment combined with FISH for detection of high-risk cytogenomic abnormalities in patients with PCNs after therapy.
  
  
  METHODS
  Twenty-eight patients with PCNs, of whom 22 received treatment, were included in this study. Plasma cells were enriched in BM aspirates by using a magnetic cell-sorting procedure to select CD138(+) cells. Probes were chosen to assess for del(17p13/TP53), del(13q14/RB1), 1q21/CKS1B gain, IgH/FGFR3, and IgH/MAF. Clinicopathologic data were collected during clinical follow-up after plasma cell enrichment.
  
  
  RESULTS
  Plasma cells in nonenriched BM specimens ranged from 1% to 28% (median, 8%) compared with 28% to 96% (median, 73%) in enriched BM specimens (P < .001). In a subset of treated patients in clinical remission, FISH detected high-risk cytogenomic abnormalities only in plasma cell-enriched samples. This approach also detected abnormalities in cases of solitary plasmacytoma and monoclonal gammopathy of undetermined significance.
  
  
  CONCLUSIONS
  Plasma cell enrichment of BM specimens increases FISH sensitivity for detecting high-risk cytogenomic abnormalities, particularly in treated patients, and these results, in combination with clinical follow-up data, can be of value to improve risk stratification and patient management.
authors.affiliation: Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. gglu@mdanderson.org
authors.forename: Gary
authors.initials: G
authors.lastname: Lu
authors.forename: Ramya
authors.initials: R
authors.lastname: Muddasani
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
authors.forename: Lynne V
authors.initials: LV
authors.lastname: Abruzzo
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
authors.forename: M James
authors.initials: MJ
authors.lastname: You
authors.forename: Yaping
authors.initials: Y
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.forename: Su
authors.initials: S
authors.lastname: Chen
authors.forename: Isabella Claudia
authors.initials: IC
authors.lastname: Glitza
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D018450:Disease Progression; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D010950:Plasma Cells / Q000473:pathology*; D010954:Plasmacytoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology