Fluorescence In Situ Hybridization on Enriched CD138-Positive Cells in Plasma Cell Myeloma

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Acta Medica International,2015,2,2,168-174.
Published:July 2015
Type:Case Report

Fluorescence In Situ Hybridization on Enriched CD138-Positive Cells in Plasma Cell Myeloma

Yu Shi1, Charalambos Solomides2, Gerald Gong3, Zi-Xuan (Zoe) Wang4, GuldeepUppal5, Vandi Ly6, Stephen C Peiper7, Peter A Herbut7, Renu Bajaj8

1Resident - PGY 4, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107,

2Director Cytopathology,Associate Professor, Thomas Jefferson University Hospital,

3Director, Hematology/Hematopathology/Flow Cytometry, Associate Professor, Thomas Jefferson University Hospital,

4Scientific Director, Molecular & Genomic Pathology Laboratory, Thomas Jefferson University Hospital, Assistant Professor, Department of Surgery & Pathology, Thomas Jefferson University,

5Assistant Professor, Pathology, Thomas Jefferson University Hospital, Philadelphia, PA 19107,

6Resident - PGY 4, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia,
PA 19107,

7Professor and chair, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107,

8Director of Cytogenetics, Assistant Professor, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107

Abstract:

To validate plasma cell enrichment technique for improving the detection of cytogenetic abnormalities in the Plasma cell myeloma (PCM)/multiple myeloma (MM). We compared the abnormality detection rate for overnight unstimulated bone marrow cultures to that for the plasma cell enriched fractions obtained with the use of CD138-coated immunomagnetic beads. Average enrichment factor (EF) was 11. One or more abnormalities were detected in 90% of enriched samples vs. 65% of non-enriched samples, thus resulting in a significantly higher detection rate of total cytogenetic abnormalities in enriched plasma cells (p=0.0038). Additional findings of RB1 deletion, TP53-, 1p-, 1q+ and IGH@ rearrangement seen in the 25% of enriched samples could contribute to the altered risk in the patient. One of the three cases with plasma cells as low as 1% by morphology was positive for a residual disease marker in the enriched sample and negative in the non-enriched sample. The plasma cell enrichment technique increased the detection rate of diagnostic and prognostic markers and is a very sensitive method for detecting minimal residual disease.

Plasma cells in enriched bone marrow samples