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Inability of a monoclonal anti-light chain antibody to detect clonal plasma cells in a patient with multiple myeloma by multicolor flow cytometry.
Cytometry B Clin Cytom. 2013 Jan-Feb; 84(1):30-2.CB

Abstract

BACKGROUND

Multicolor flow cytometry (MFC) is increasingly important for the diagnosis and minimal residual disease (MRD) assessment of patients with plasma cells (PC) dyscrasias, like multiple myeloma. Recently published information shows that immunophenotype of myeloma PC can change over time and normal PC are heterogeneous in the expression of CD19 and CD56. This implies that for a sensitive, reliable detection of MRD clonality assessment by the detection of cytoplasmic kappa and lambda light chains is advisable.

METHODS

Eight-color MFC was used to detect normal and myeloma PC by the expression of CD38 and CD138. Analysis of additional surface antigens like CD45, CD19, CD56, CD27, and the intracellular immunoglobulin light chain distribution were used to differentiate polyclonal from clonal PC.

RESULTS

Absence of cytoplasmic light chains expression in a PC subpopulation with an abnormal phenotype suggested the presence of non-secretory plasma cells in the bone marrow (BM) of this patient. This observation however, was contradicted by the presence of free lambda light chains in the patient's serum. After repeating the analysis with polyclonal antibodies against intracellular immunoglobulin light chains instead of monoclonal antibodies, the abnormal PC subpopulation appeared to express lambda light chains.

CONCLUSION

These data illustrate that if clonality assessment of PC is included in disease monitoring, the use of polyclonal over monoclonal antibodies is preferred for the detection of intracellular immunoglobulin light chains.

Authors+Show Affiliations

Department of Medical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. J.vanvelzen@umcutrecht.nlNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23019187

Citation

van Velzen, Jeroen F., et al. "Inability of a Monoclonal Anti-light Chain Antibody to Detect Clonal Plasma Cells in a Patient With Multiple Myeloma By Multicolor Flow Cytometry." Cytometry. Part B, Clinical Cytometry, vol. 84, no. 1, 2013, pp. 30-2.
van Velzen JF, van den Blink D, Bloem AC. Inability of a monoclonal anti-light chain antibody to detect clonal plasma cells in a patient with multiple myeloma by multicolor flow cytometry. Cytometry B Clin Cytom. 2013;84(1):30-2.
van Velzen, J. F., van den Blink, D., & Bloem, A. C. (2013). Inability of a monoclonal anti-light chain antibody to detect clonal plasma cells in a patient with multiple myeloma by multicolor flow cytometry. Cytometry. Part B, Clinical Cytometry, 84(1), 30-2. https://doi.org/10.1002/cyto.b.21044
van Velzen JF, van den Blink D, Bloem AC. Inability of a Monoclonal Anti-light Chain Antibody to Detect Clonal Plasma Cells in a Patient With Multiple Myeloma By Multicolor Flow Cytometry. Cytometry B Clin Cytom. 2013 Jan-Feb;84(1):30-2. PubMed PMID: 23019187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inability of a monoclonal anti-light chain antibody to detect clonal plasma cells in a patient with multiple myeloma by multicolor flow cytometry. AU - van Velzen,Jeroen F, AU - van den Blink,Dorine, AU - Bloem,Andries C, Y1 - 2012/09/27/ PY - 2012/04/05/received PY - 2012/07/31/revised PY - 2012/08/28/accepted PY - 2012/9/29/entrez PY - 2012/9/29/pubmed PY - 2013/6/26/medline SP - 30 EP - 2 JF - Cytometry. Part B, Clinical cytometry JO - Cytometry B Clin Cytom VL - 84 IS - 1 N2 - BACKGROUND: Multicolor flow cytometry (MFC) is increasingly important for the diagnosis and minimal residual disease (MRD) assessment of patients with plasma cells (PC) dyscrasias, like multiple myeloma. Recently published information shows that immunophenotype of myeloma PC can change over time and normal PC are heterogeneous in the expression of CD19 and CD56. This implies that for a sensitive, reliable detection of MRD clonality assessment by the detection of cytoplasmic kappa and lambda light chains is advisable. METHODS: Eight-color MFC was used to detect normal and myeloma PC by the expression of CD38 and CD138. Analysis of additional surface antigens like CD45, CD19, CD56, CD27, and the intracellular immunoglobulin light chain distribution were used to differentiate polyclonal from clonal PC. RESULTS: Absence of cytoplasmic light chains expression in a PC subpopulation with an abnormal phenotype suggested the presence of non-secretory plasma cells in the bone marrow (BM) of this patient. This observation however, was contradicted by the presence of free lambda light chains in the patient's serum. After repeating the analysis with polyclonal antibodies against intracellular immunoglobulin light chains instead of monoclonal antibodies, the abnormal PC subpopulation appeared to express lambda light chains. CONCLUSION: These data illustrate that if clonality assessment of PC is included in disease monitoring, the use of polyclonal over monoclonal antibodies is preferred for the detection of intracellular immunoglobulin light chains. SN - 1552-4957 UR - https://www.unboundmedicine.com/medline/citation/23019187/Inability_of_a_monoclonal_anti_light_chain_antibody_to_detect_clonal_plasma_cells_in_a_patient_with_multiple_myeloma_by_multicolor_flow_cytometry_ L2 - https://doi.org/10.1002/cyto.b.21044 DB - PRIME DP - Unbound Medicine ER -