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Increased circulating plasma cells detected by flow cytometry predicts poor prognosis in patients with plasma cell myeloma.
Cytometry B Clin Cytom. 2018 05; 94(3):493-499.CB

Abstract

BACKGROUND

Flow cytometry (FC) is a reliable tool for diagnosing and monitoring of plasma cell myeloma (PCM). Recent studies used FC for quantifying plasma cells (PCs) in peripheral blood (PB) using various panels, and an adverse prognostic effect of circulating PCs (cPCs) has been reported. We investigated the prognostic implication of cPCs quantified using a simple panel in patients with PCM.

METHODS

Bone marrow (BM) and PB of 85 patients with PCM were analyzed by five-color FC at time of diagnosis. A serial gating strategy for quantification used CD38/CD138 to gate PCs in 100,000-200,000 acquired events, with subsequent gating for CD19, CD56, and CD45, to identify aberrant immunophenotypes.

RESULTS

cPCs were observed in 74.1% patients (63/85, median 0.067% leukocytes). Patients were grouped based on a cPC cut-off level of 0.02% derived using the receiver operating characteristic curves. Compared with patients with cPCs < 0.02% (n = 28), those with cPCs ≥ 0.02% (n = 57) showed lower hemoglobin (P = 0.003) and platelets (P = 0.014), but higher calcium, M-protein and BM PCs (P = 0.013, 0.029, and P < 0.001, respectively). Survival analysis of 74 patients showed that cPCs ≥ 0.02% predicted shorter progression-free and overall survival (P = 0.001 and 0.013, respectively), and this negative prognostic impact was retained in multivariate analysis (P = 0.023).

CONCLUSIONS

Flow cytometric quantification of cPCs using five surface antigens (CD138, CD38, CD56, CD19, and CD45) is a sensitive and simple method that can be used for assessing PCM prognosis; it would allow clinical laboratories to readily adopt a risk stratification strategy based on cPC levels in PCM patients. © 2017 International Clinical Cytometry Society.

Authors+Show Affiliations

Department of Laboratory Medicine, Hanyang University Guri Hospital, Guri, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29220877

Citation

Bae, Mi Hyun, et al. "Increased Circulating Plasma Cells Detected By Flow Cytometry Predicts Poor Prognosis in Patients With Plasma Cell Myeloma." Cytometry. Part B, Clinical Cytometry, vol. 94, no. 3, 2018, pp. 493-499.
Bae MH, Park CJ, Kim BH, et al. Increased circulating plasma cells detected by flow cytometry predicts poor prognosis in patients with plasma cell myeloma. Cytometry B Clin Cytom. 2018;94(3):493-499.
Bae, M. H., Park, C. J., Kim, B. H., Cho, Y. U., Jang, S., Lee, D. H., Seo, E. J., Yoon, D. H., Lee, J. H., & Suh, C. (2018). Increased circulating plasma cells detected by flow cytometry predicts poor prognosis in patients with plasma cell myeloma. Cytometry. Part B, Clinical Cytometry, 94(3), 493-499. https://doi.org/10.1002/cyto.b.21606
Bae MH, et al. Increased Circulating Plasma Cells Detected By Flow Cytometry Predicts Poor Prognosis in Patients With Plasma Cell Myeloma. Cytometry B Clin Cytom. 2018;94(3):493-499. PubMed PMID: 29220877.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased circulating plasma cells detected by flow cytometry predicts poor prognosis in patients with plasma cell myeloma. AU - Bae,Mi Hyun, AU - Park,Chan-Jeoung, AU - Kim,Bo Hyun, AU - Cho,Young-Uk, AU - Jang,Seongsoo, AU - Lee,Dong-Hyun, AU - Seo,Eul-Ju, AU - Yoon,Dok Hyun, AU - Lee,Jung-Hee, AU - Suh,Cheolwon, Y1 - 2017/12/29/ PY - 2017/08/13/received PY - 2017/11/30/revised PY - 2017/12/05/accepted PY - 2017/12/9/pubmed PY - 2019/5/9/medline PY - 2017/12/9/entrez KW - circulating plasma cells KW - flow cytometry KW - plasma cell myeloma KW - prognosis SP - 493 EP - 499 JF - Cytometry. Part B, Clinical cytometry JO - Cytometry B Clin Cytom VL - 94 IS - 3 N2 - BACKGROUND: Flow cytometry (FC) is a reliable tool for diagnosing and monitoring of plasma cell myeloma (PCM). Recent studies used FC for quantifying plasma cells (PCs) in peripheral blood (PB) using various panels, and an adverse prognostic effect of circulating PCs (cPCs) has been reported. We investigated the prognostic implication of cPCs quantified using a simple panel in patients with PCM. METHODS: Bone marrow (BM) and PB of 85 patients with PCM were analyzed by five-color FC at time of diagnosis. A serial gating strategy for quantification used CD38/CD138 to gate PCs in 100,000-200,000 acquired events, with subsequent gating for CD19, CD56, and CD45, to identify aberrant immunophenotypes. RESULTS: cPCs were observed in 74.1% patients (63/85, median 0.067% leukocytes). Patients were grouped based on a cPC cut-off level of 0.02% derived using the receiver operating characteristic curves. Compared with patients with cPCs < 0.02% (n = 28), those with cPCs ≥ 0.02% (n = 57) showed lower hemoglobin (P = 0.003) and platelets (P = 0.014), but higher calcium, M-protein and BM PCs (P = 0.013, 0.029, and P < 0.001, respectively). Survival analysis of 74 patients showed that cPCs ≥ 0.02% predicted shorter progression-free and overall survival (P = 0.001 and 0.013, respectively), and this negative prognostic impact was retained in multivariate analysis (P = 0.023). CONCLUSIONS: Flow cytometric quantification of cPCs using five surface antigens (CD138, CD38, CD56, CD19, and CD45) is a sensitive and simple method that can be used for assessing PCM prognosis; it would allow clinical laboratories to readily adopt a risk stratification strategy based on cPC levels in PCM patients. © 2017 International Clinical Cytometry Society. SN - 1552-4957 UR - https://www.unboundmedicine.com/medline/citation/29220877/Increased_circulating_plasma_cells_detected_by_flow_cytometry_predicts_poor_prognosis_in_patients_with_plasma_cell_myeloma_ L2 - https://doi.org/10.1002/cyto.b.21606 DB - PRIME DP - Unbound Medicine ER -