1
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Dorfman DM, Devitt KA, Cui W, Bashleben C, Naharro ECF, Hedley B, Hupp M, Karlon WJ, Murphy CE, Cherian S, Olteanu H, Seifert RP, Rosado FN, Linden MA. PCNEO, a New Proficiency Testing Program for Flow Cytometric Analysis of Plasma Cell Neoplasms From the College of American Pathologists Diagnostic Immunology and Flow Cytometry Committee. Arch Pathol Lab Med 2024; 148:699-704. [PMID: 37776247 DOI: 10.5858/arpa.2023-0035-cp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 10/02/2023]
Abstract
CONTEXT.— In 2018 the College of American Pathologists Diagnostic Immunology and Flow Cytometry Committee designed and implemented a new plasma cell neoplasia flow cytometry proficiency testing program-PCNEO-to allow clinical flow cytometry laboratories to monitor and assess their performance compared with a peer group. OBJECTIVE.— To report the results from the first 4 years of the PCNEO program. DESIGN.— Program participants were sent 2 sets of challenges per year, each including 1 wet challenge and 2 dry challenges, with associated clinical and laboratory findings. The wet challenges were composed of myeloma cell line specimens (with or without dilution in preserved whole blood) for flow cytometric analysis. The dry (paper) challenges were composed of clinical case summaries and images of flow cytometric test results from various flow cytometry laboratories of committee members. RESULTS.— A total of 116 to 145 laboratories from 17 countries enrolled in the proficiency testing program. For the wet challenges, almost all participants (97%-100%; cumulative, 98.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of undiluted myeloma cell lines. Slightly fewer participants (89.0%-97.4%; cumulative, 95.2%) correctly identified the presence of neoplastic plasma cell populations based on flow cytometric analysis of diluted myeloma cell lines (10% or 50% dilutions into peripheral blood) intended to better represent a typical clinical sample. There was generally agreement among 80% or more of participants for positive or negative staining for CD38, CD138, CD19, CD20, and surface and cytoplasmic κ and λ light chains. Similarly, 84% to 100% of participants were able to correctly identify the presence of neoplastic plasma cell populations in paper challenges, including the presence of small, neoplastic plasma cell populations (0.01%-5.0% clonal plasma cells) and the presence of nonneoplastic plasma cell populations (correctly identified by 91%-96% of participants). CONCLUSIONS.— Participant performance in the new proficiency testing program was excellent overall, with the vast majority of participants able to perform flow cytometric analysis and identify neoplastic plasma cell populations and to identify small plasma cell clones or expanded populations of reactive plasma cells in dry challenge flow cytometry results. This program will allow laboratories to verify the accuracy of their testing program and test interpretations for the assessment of patients suspected of having a plasma cell neoplasm.
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Affiliation(s)
- David M Dorfman
- From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dorfman)
| | - Katherine A Devitt
- the Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington (Devitt)
| | - Wei Cui
- the Department of Pathology and Laboratory Medicine, University of Kansas Health System, Kansas City (Cui)
| | - Christine Bashleben
- Laboratory Improvement Programs, Surveys, College of American Pathologists, Northfield, Illinois (Bashleben)
| | - Elena C Frye Naharro
- the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Naharro, Hupp, Linden)
| | - Benjamin Hedley
- the Department of Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada (Hedley)
| | - Meghan Hupp
- the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Naharro, Hupp, Linden)
| | - William J Karlon
- the Department of Laboratory Medicine, University of California, San Francisco (Karlon)
| | | | - Sindhu Cherian
- the Department of Laboratory Medicine and Pathology, University of Washington, Seattle (Cherian)
| | - Horatiu Olteanu
- the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (Olteanu)
| | - Robert P Seifert
- the Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville (Seifert)
| | - Flavia N Rosado
- the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Rosado)
| | - Michael A Linden
- the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Naharro, Hupp, Linden)
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2
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Amalbert T, Canonne AM, Béguin J. Myelomatous pleural effusion in a cat diagnosed with multiple myeloma. JFMS Open Rep 2023; 9:20551169221134094. [PMID: 36755800 PMCID: PMC9899953 DOI: 10.1177/20551169221134094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Case summary A 10-year-old male castrated domestic shorthair cat was presented with a 3-day history of dyspnoea, chronic lethargy and inappetence. A bilateral pleural effusion was identified by thoracic ultrasound, and cytological examination revealed numerous atypical plasma cells. Biochemistry and serum protein electrophoresis revealed a severe hyperglobulinaemia associated with a monoclonal gammopathy. A moderate non-regenerative anaemia was also noted. Multiple bone lytic lesions were detected, and marked plasmacytosis was observed on bone marrow aspirates. Chemotherapy with cyclophosphamide and prednisolone was initiated but did not result in any clinical or biological response, and pleural effusion recurred. Lack of therapeutic response led to euthanasia 2 months after diagnosis. Relevance and novel information This is the first description of a myelomatous pleural effusion in a cat diagnosed with multiple myeloma and should be considered as one of the possible differential diagnoses for cats presented with pleural effusion and hyperglobulinaemia. The diagnostic, therapeutic and prognostic aspects of this manifestation are discussed.
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Affiliation(s)
- Tancrède Amalbert
- National Veterinary School of Alfort,
Paris-Est University, Maisons-Alfort, France
| | - Aude Morgane Canonne
- Department of Internal Medicine,
National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort,
France,Aude Morgane Canonne DVM, DipECVIM-CA,
Department of Internal Medicine, National Veterinary School of Alfort, 7 Av. du
Général de Gaulle, Maisons-Alfort 94700, France
| | - Jérémy Béguin
- Department of Internal Medicine,
National Veterinary School of Alfort, Paris-Est University, Maisons-Alfort,
France
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3
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Preglej T, Brinkmann M, Steiner G, Aletaha D, Göschl L, Bonelli M. Advanced immunophenotyping: A powerful tool for immune profiling, drug screening, and a personalized treatment approach. Front Immunol 2023; 14:1096096. [PMID: 37033944 PMCID: PMC10080106 DOI: 10.3389/fimmu.2023.1096096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Various autoimmune diseases are characterized by distinct cell subset distributions and activation profiles of peripheral blood mononuclear cells (PBMCs). PBMCs can therefore serve as an ideal biomarker material, which is easily accessible and allows for screening of multiple cell types. A detailed understanding of the immune landscape is critical for the diagnosis of patients with autoimmune diseases, as well as for a personalized treatment approach. In our study, we investigate the potential of multi-parameter spectral flow cytometry for the identification of patients suffering from autoimmune diseases and its power as an evaluation tool for in vitro drug screening approaches (advanced immunophenotyping). We designed a combination of two 22-color immunophenotyping panels for profiling cell subset distribution and cell activation. Downstream bioinformatics analyses included percentages of individual cell populations and median fluorescent intensity of defined markers which were then visualized as heatmaps and in dimensionality reduction approaches. In vitro testing of epigenetic immunomodulatory drugs revealed an altered activation status upon treatment, which supports the use of spectral flow cytometry as a high-throughput drug screening tool. Advanced immunophenotyping might support the exploration of novel therapeutic drugs and contribute to future personalized treatment approaches in autoimmune diseases and beyond.
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Affiliation(s)
| | | | | | | | - Lisa Göschl
- *Correspondence: Lisa Göschl, ; Michael Bonelli,
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4
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Moore AR. Diagnosing Multiple Myeloma and Related Disorders. Vet Clin North Am Small Anim Pract 2023; 53:101-120. [DOI: 10.1016/j.cvsm.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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5
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Gao Q, Chen X, Cherian S, Roshal M. Mature B‐ and plasma‐cell flow cytometric analysis: A review of the impact of targeted therapy. CYTOMETRY PART B: CLINICAL CYTOMETRY 2022; 104:224-242. [PMID: 36321879 DOI: 10.1002/cyto.b.22097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Flow cytometry has been indispensable in diagnosing B cell lymphoma and plasma cell neoplasms. The advances in novel multicolor flow cytometry have also made this technology a robust tool for monitoring minimal/measurable residual disease in chronic lymphocytic leukemia and multiple myeloma. However, challenges using conventional gating strategies to isolate neoplastic B or plasma cells are emerging due to the rapidly increasing number of antibody therapeutics targeting single or multiple classic B/plasma cell-lineage markers, such as CD19, CD20, and CD22 in B cells and CD38 in plasma cells. This review is the first of a two-part series that summarizes the most current targeted therapies used in B and plasma cell neoplasms and proposes detailed alternative approaches to overcome post-targeted therapy analysis challenges by flow cytometry. The second review in this series (Chen et al.) focuses on challenges encountered in the use of targeted therapy in precursor B cell neoplasms.
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Affiliation(s)
- Qi Gao
- Hematopathology Service, Department of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USA
| | - Xueyan Chen
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA USA
| | - Sindu Cherian
- Department of Laboratory Medicine and Pathology University of Washington Seattle WA USA
| | - Mikhail Roshal
- Hematopathology Service, Department of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York New York USA
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6
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Bailly J, Jenkins N, Chetty D, Mohamed Z, Verburgh ER, Opie JJ. Plasmablastic lymphoma: An update. Int J Lab Hematol 2022; 44 Suppl 1:54-63. [PMID: 36074710 PMCID: PMC9545967 DOI: 10.1111/ijlh.13863] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/20/2022] [Indexed: 12/22/2022]
Abstract
Plasmablastic lymphoma (PBL) is a highly aggressive B cell non-Hodgkin lymphoma frequently associated with immunosuppression, particularly human immunodeficiency virus (HIV) infection. Although PBL is rare globally, South Africa has a high burden of HIV infection leading to a higher incidence of PBL in the region. Laboratory features in PBL may overlap with plasmablastic myeloma and other large B cell lymphomas with plasmablastic or immunoblastic morphology leading to diagnostic dilemmas. There are, however, pertinent distinguishing laboratory features in PBL such as a plasma cell immunophenotype with MYC overexpression, expression of Epstein-Barr virus-encoded small RNAs and lack of anaplastic lymphoma kinase (ALK) expression. This review aims to provide a summary of current knowledge in PBL, focusing on the epidemiology, pathophysiology, laboratory diagnosis and clinical management.
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Affiliation(s)
- Jenique Bailly
- Division of Haematology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Nicholas Jenkins
- Division of Haematology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Dharshnee Chetty
- Division of Anatomical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Zainab Mohamed
- Department of Radiation Oncology, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Estelle R Verburgh
- Division of Haematology, Department of Internal Medicine, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Jessica J Opie
- Division of Haematology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
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7
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Mandy F. Issue Highlights-January 2022. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:11-13. [PMID: 35044089 DOI: 10.1002/cyto.b.22055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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8
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El Hussein S, Wang W, Wang SA, Fang H, Garces S, Tashakori M, Lyapichev KA, Qiu L, Wang X, Loghavi S, Medeiros LJ, Challagundla P, Jorgensen JL. Hematogones with light chain restriction: A potential diagnostic pitfall when using flow cytometry analysis to assess bone marrow specimens. Leuk Res 2021; 111:106704. [PMID: 34735934 DOI: 10.1016/j.leukres.2021.106704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/20/2022]
Abstract
Light-chain restricted hematogones (LCR HGs) detected by flow cytometry analysis can mimic bone marrow involvement by B-cell lymphoma. This phenomenon can present a diagnostic pitfall and negatively impact patient management, as misinterpretation may upgrade disease stage. In this study, we characterized the immunophenotype of LCR HGs with an aim to differentiate them from B-cell lymphoma. We analyzed 24 patients with LCR HGs, 12 (50 %) were kappa light chain restricted and 12 (50 %) were lambda light chain restricted. LCR HGs account for 51 % (range, 1.5%-99%) of B cells, and 0.5 % (range, 0.1%-3.7%) of total cells. In 15 patients in whom multiple specimens were analyzed, 10 (67 %) showed persistent LCR HGs in more than 1 specimen, and the duration of the light chain restriction ranged from 4 months to 2 years. Among 24 patients, 4 (16.6 %) cases were concurrently involved by B-cell lymphoma/myeloma in addition to LCR HGs. With the exception of light chain restriction, LCR HGs showed a similar immunophenotype as normal HGs and had a distinct location on the CD45/Side Scatter (SSC) plot. They were also consistently positive for CD10, CD19, CD38 (bright), CD43, and CD200. CD20 expression showed a spectrum from dim/negative to positive.
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Affiliation(s)
- Siba El Hussein
- University of Rochester Medical Center, Department of Pathology, Rochester, New York, USA; The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA.
| | - Wei Wang
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Sa A Wang
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Hong Fang
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Sofia Garces
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Mehrnoosh Tashakori
- The University of Minnesota, Department of Pathology, Minneapolis, Minnesota, USA
| | - Kirill A Lyapichev
- University of Texas Medical Branch, Department of Pathology, Galveston, Texas, USA
| | - Lianqun Qiu
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Xiaoqiong Wang
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Sanam Loghavi
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - L Jeffrey Medeiros
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA
| | - Pramoda Challagundla
- Takeda Pharmaceutical International Co., OTAU Precision and Translation Medicine, Cambridge, Massachusetts, USA
| | - Jeffrey L Jorgensen
- The University of Texas MD Anderson Cancer Center, Department of Hematopathology, Houston, Texas, USA.
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9
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Ng DP. Flow cytometric myeloma measurable residual disease testing in the era of targeted therapies. Int J Lab Hematol 2021; 43 Suppl 1:71-77. [PMID: 34288444 DOI: 10.1111/ijlh.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
Therapies in myeloma are rapidly advancing with a host of new targeted therapies coming to market. While these drugs offer significant survival benefits and better side-effect profiles compared with conventional chemotherapeutics, they raise significant difficulties in monitoring post-therapy disease status by flow cytometry due to assay interference and/or selection of phenotypically different sub-clones. The principal culprit, anti-CD38 monoclonal antibodies, limits the ability to detect plasma cells based on classical CD38/CD45 gating. Other markers, such as CD138, are known to be suboptimal by flow cytometry. Various techniques have been proposed to overcome this problem. The most promising of these techniques has been the marker VS38c, a monoclonal antibody targeting an endoplasmic reticulum protein which has shown high sensitivity for plasma cells. Alternative techniques for gating plasma cells, while variably effective in the near term are already the subject of several targeted therapies rendering their usefulness limited in the longer term. Likewise, future targets of these therapies may render present aberrancy markers ineffective in MRD testing. These therapies pose challenges that must be overcome with new markers and novel panels in order for flow cytometric MRD testing to remain relevant.
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Affiliation(s)
- David P Ng
- University of Utah, Salt Lake City, UT, USA
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10
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DiGiuseppe JA. Issue Highlights-July 2021. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 100:393-396. [PMID: 34292659 DOI: 10.1002/cyto.b.22027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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11
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Silva A, Silva S, Silva I, Santos S, Laranjeira P, Geraldes C, Silva H, Sarmento-Ribeiro AB, Nascimento T, Domingues P, Paiva A. Bone marrow follicular-like T cells in monoclonal gammopathies. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 102:70-72. [PMID: 34245490 DOI: 10.1002/cyto.b.22029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Ana Silva
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Sandra Silva
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Isabel Silva
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Susana Santos
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Paula Laranjeira
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | - Catarina Geraldes
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Laboratory of Oncobiology and Haematology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Helena Silva
- Clinical Hematology Department, Centro Hospitalar Tondela-Viseu EPE, Viseu, Portugal
| | - Ana Bela Sarmento-Ribeiro
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Laboratory of Oncobiology and Haematology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Telma Nascimento
- Clinical Hematology Department, Centro Hospitalar do Baixo Vouga EPE, Aveiro, Portugal
| | - Pedro Domingues
- Department of Chemistry, Mass Spectrometry Centre, LAQV Requimte, University of Aveiro, Aveiro, Portugal
| | - Artur Paiva
- Flow Cytometry Unit, Clinical Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Ciências Biomédicas Laboratoriais, ESTESC-Coimbra Health School, Instituto Politécnico de Coimbra, Coimbra, Portugal
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12
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Abstract
Immunotherapy marked a milestone in cancer treatment and has shown unprecedented efficacy in a variety of hematological malignancies. Downregulation or loss of target antigens is commonly seen after immunotherapy, which often causes diagnostic dilemma and represents a key mechanism that tumor escapes from immunotherapy. The awareness of phenotypic changes after targeted immunotherapy is important to avoid misdiagnosis. Further understanding of the mechanisms of antigen loss is paramount for the development of therapeutic approaches that can prevent or overcome antigen escape in future immunotherapy.
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Affiliation(s)
- Ting Zhou
- Flow Cytometry Unit, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hao-Wei Wang
- Flow Cytometry Unit, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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13
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Mizuta S, Yamane N, Mononobe S, Watanabe A, Matsuki S, Komai T, Koba Y, Mitani S, Kawata T, Tamekane A, Watanabe M. VS38 staining contributes to a novel gating strategy in flow cytometry for small B cell lymphoma, especially in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 102:50-61. [PMID: 33682304 DOI: 10.1002/cyto.b.22000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/08/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Multi-parametric flow cytometry (MFC) is a helpful tool for detecting neoplastic cells in malignant lymphoma; however, lymphoma cells can be difficult to detect when characteristic immunophenotypic abnormalities are not evident. We evaluated the stainability of VS38, which is used for multiple myeloma, in normal and abnormal B cells using MFC to develop a new strategy for detecting lymphoma cells. METHODS We compared the median fluorescence intensity of VS38 staining in lymphocytes from patients without hematopoietic neoplasms and in B cells from 26 patients with B cell lymphoma (BCL). To evaluate the performance of VS38 gating, we compared VS38-positive B cells with the percentages of BCL cells, and with the mutation ratios of MYD88 L265P measured by droplet digital PCR in patients with lymphoplasmacytic lymphoma (LPL)/Waldenström macroglobulinemia (WM). RESULTS CD27-positive memory B cells were stained with VS38, whereas normal lymphocytes were faintly stained. Lymphoma cells were stained with VS38 in 11 of 12 patients with LPL/WM, 3 of 3 with chronic lymphocytic leukemia, 3 of 5 with mantle cell lymphoma, 2 of 4 with follicular lymphoma, and 1 of 1 with splenic marginal zone lymphoma. The percentages of VS38-positive B cells in VS38-positive BCL were equivalent to those of lymphoma cells and the mutation ratios of MYD88 L265P in LPL/WM. CONCLUSIONS VS38 identified neoplastic cells in plasma cell disorders and BCL. This might improve the accuracy of BCL diagnosis, especially in patients with LPL/WM.
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Affiliation(s)
- Shumpei Mizuta
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.,Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Noriko Yamane
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Saya Mononobe
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Asami Watanabe
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Shinichiro Matsuki
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Takao Komai
- Department of Clinical Laboratory, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Yusuke Koba
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Sachiko Mitani
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Takahito Kawata
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.,Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Tamekane
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Mitsumasa Watanabe
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
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14
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Kern W. Issue Highlights - September 2019. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 96:335-337. [PMID: 31566911 DOI: 10.1002/cyto.b.21848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/21/2019] [Accepted: 09/05/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Wolfgang Kern
- MLL Munich Leukemia Laboratory, Max-Lebsche-Platz 31, Munich, Germany
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15
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Yu J, Tan L, Wu Q, Rao Y, Ao J, Yang W, Zou B, Chen J. Multiple myeloma with CD138 changed from positive to negative: A case report. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:249-253. [PMID: 31967404 DOI: 10.1002/cyto.b.21869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Multiple myeloma (MM) is a common malignant disease of the blood system, caused by the neoplastic proliferation of plasma cells that accumulate in bone marrow (BM). Here, we report a case of MM patient with CD138 marker changed from positive to negative. METHODS BM and peripheral blood samples from a 48-year-old patient with MM were examined and analyzed by conventional morphology, flow cytometry, and immunodetection. RESULTS Imaging examination and clinical manifestations fulfilled criteria for MM. On the first hospitalization, flow cytometry showed that the cells were CD138+ /CD38+ /CD19- /CD56+ . However, on the fifth hospitalization, flow cytometry revealed that the cells were CD138- /CD38+ /CD19- /CD56+ . CONCLUSIONS MM is diagnosed on imaging and clinical manifestations, immunophenotype of flow cytometry is also an important method of diagnosing MM. However, the discovery of atypical immunophenotypes cannot prevent the diagnosis of MM, even provide a clue of disease progression.
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Affiliation(s)
- Jianlin Yu
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liming Tan
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qiong Wu
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanfei Rao
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jianyun Ao
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Weiming Yang
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bei Zou
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Juanjuan Chen
- Jiangxi Province Key Laboratory of Laboratory Medicine, Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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