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Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: A Single Institutional Study.
Clin Lymphoma Myeloma Leuk. 2016 Mar; 16(3):e27-37.CL

Abstract

BACKGROUND

Plasma cell neoplasm is a common hematologic malignancy. Treatment with novel agents results in favorable outcomes. Reliable investigations are required to monitor the residual disease, especially after such effective treatments. Flow cytometric analysis is a speedy and accurate method to detect abnormal cells. The aim of this study was to determine diagnostic performance of flow cytometry in the detection of abnormal plasma cells in bone marrow specimens.

MATERIALS AND METHODS

We included bone marrow samples taken from patients suspected to harbor plasma cell neoplasm at the time of diagnosis or follow-up after treatment from 2013 to 2015. Flow cytometric analyses, using cluster of differentiation (CD)19/CD20/CD27/CD38/CD45/CD56/CD117/CD138 and cytoplasmic κ/λ, were done and results compared with morphologic evaluation of marrow aspirate smear, histology, and immunohistochemistry of marrow biopsy and protein electrophoretic analyses.

RESULTS

A total of 154 specimens were included. Plasma cell neoplasm was detected in 56 samples (36.4%). Most abnormal plasma cells in this study were CD19-negative (CD19(-))/CD20(-)/CD27(+)/CD38(+)/CD45(-) (or weakly positive)/CD56(+)/CD117(+)/CD138(+). Light chain restriction was found only in 18 samples (32.1%). Sensitivity and specificity of flow cytometric analysis were 91.1% and 96.9%, respectively. For the follow-up cohort, sensitivity and specificity were 86.7% and 66.7%, respectively.

CONCLUSION

Analysis of plasma cell neoplasm using flow cytometry has high sensitivity and specificity. As an adjunct to marrow histology and immunohistochemistry, flow cytometry can be used in diagnosis of plasma cell neoplasm and more importantly in monitoring the disease after treatment. We propose a limited panel of CD19/CD38/CD45/CD56/CD117/CD138 for detecting minimal residual disease in Thai patients.

Authors+Show Affiliations

Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. Electronic address: wasithep@tu.ac.th.Pathology Unit, Thammasat University Hospital, Pathumthani, Thailand.Pathology Unit, Thammasat University Hospital, Pathumthani, Thailand.Department of Pathology and Forensic Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26796980

Citation

Limvorapitak, Wasithep, et al. "Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: a Single Institutional Study." Clinical Lymphoma, Myeloma & Leukemia, vol. 16, no. 3, 2016, pp. e27-37.
Limvorapitak W, Srisum-Ang T, Chimres C, et al. Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: A Single Institutional Study. Clin Lymphoma Myeloma Leuk. 2016;16(3):e27-37.
Limvorapitak, W., Srisum-Ang, T., Chimres, C., Warnnissorn, N., & Kanitsap, N. (2016). Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: A Single Institutional Study. Clinical Lymphoma, Myeloma & Leukemia, 16(3), e27-37. https://doi.org/10.1016/j.clml.2015.12.002
Limvorapitak W, et al. Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: a Single Institutional Study. Clin Lymphoma Myeloma Leuk. 2016;16(3):e27-37. PubMed PMID: 26796980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of Bone Marrow Flow Cytometry Analysis in Patients With Plasma Cell Neoplasm in Thailand: A Single Institutional Study. AU - Limvorapitak,Wasithep, AU - Srisum-Ang,Thammasiree, AU - Chimres,Chutima, AU - Warnnissorn,Naree, AU - Kanitsap,Nonglak, Y1 - 2015/12/17/ PY - 2015/09/05/received PY - 2015/11/25/revised PY - 2015/12/08/accepted PY - 2016/1/23/entrez PY - 2016/1/23/pubmed PY - 2016/12/15/medline KW - Immunophenotype KW - Minimal residual disease KW - Multiple myeloma KW - Sensitivity KW - Specificity SP - e27 EP - 37 JF - Clinical lymphoma, myeloma & leukemia JO - Clin Lymphoma Myeloma Leuk VL - 16 IS - 3 N2 - BACKGROUND: Plasma cell neoplasm is a common hematologic malignancy. Treatment with novel agents results in favorable outcomes. Reliable investigations are required to monitor the residual disease, especially after such effective treatments. Flow cytometric analysis is a speedy and accurate method to detect abnormal cells. The aim of this study was to determine diagnostic performance of flow cytometry in the detection of abnormal plasma cells in bone marrow specimens. MATERIALS AND METHODS: We included bone marrow samples taken from patients suspected to harbor plasma cell neoplasm at the time of diagnosis or follow-up after treatment from 2013 to 2015. Flow cytometric analyses, using cluster of differentiation (CD)19/CD20/CD27/CD38/CD45/CD56/CD117/CD138 and cytoplasmic κ/λ, were done and results compared with morphologic evaluation of marrow aspirate smear, histology, and immunohistochemistry of marrow biopsy and protein electrophoretic analyses. RESULTS: A total of 154 specimens were included. Plasma cell neoplasm was detected in 56 samples (36.4%). Most abnormal plasma cells in this study were CD19-negative (CD19(-))/CD20(-)/CD27(+)/CD38(+)/CD45(-) (or weakly positive)/CD56(+)/CD117(+)/CD138(+). Light chain restriction was found only in 18 samples (32.1%). Sensitivity and specificity of flow cytometric analysis were 91.1% and 96.9%, respectively. For the follow-up cohort, sensitivity and specificity were 86.7% and 66.7%, respectively. CONCLUSION: Analysis of plasma cell neoplasm using flow cytometry has high sensitivity and specificity. As an adjunct to marrow histology and immunohistochemistry, flow cytometry can be used in diagnosis of plasma cell neoplasm and more importantly in monitoring the disease after treatment. We propose a limited panel of CD19/CD38/CD45/CD56/CD117/CD138 for detecting minimal residual disease in Thai patients. SN - 2152-2669 UR - https://www.unboundmedicine.com/medline/citation/26796980/Accuracy_of_Bone_Marrow_Flow_Cytometry_Analysis_in_Patients_With_Plasma_Cell_Neoplasm_in_Thailand:_A_Single_Institutional_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2152-2650(15)01416-0 DB - PRIME DP - Unbound Medicine ER -