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Gayet M, Leymarie V, Derouault P, Guérin E, Vaidié J, Pascal V, Boulin M, Dmytruk N, Chauzeix J, Trimoreau F, Gachard N, Feuillard J, Rizzo D. Flow cytometry detection of CD138 expression continuum between monotypic B and plasma cells is associated with both high IgM peak levels and MYD88 mutation and contributes to diagnosis of Waldenström macroglobulinemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2021; 102:62-69. [PMID: 33634586 DOI: 10.1002/cyto.b.21995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/13/2021] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Differential diagnosis of Waldenström macroglobulinemia (WM) with other indolent B-cell malignancies is still a challenge. Here, we propose an original and simple analysis of routine flow cytometry (FCM) unraveling the characteristic ongoing plasma cell (PC) differentiation of WM tumor B-cells. METHODS FCM analysis of both B-cells and PC was performed on a series of 77 patients with IgM peak. MYD88 and CXCR4 mutations were studied using an allele-specific PCR and by high throughput sequencing. RESULTS Twenty seven (35%), 46 (58%) and 4 (5%) patients were classified as WM, IgM monoclonal gammopathy of undetermined significance (MGUS) or other B-NHL respectively. MYD88 mutation was found in 25/27 WM (93%) and in 29/46 MGUS (63%). Using FCM, monotypic B-cells were found in 27/27 WM (100%) and 34/46 MGUS (74%). Monotypic CD138pos/CD38pos PCs were detected in 23/27 WM (85%) and 25/46 MGUS (54%). Highlighting the ongoing PC differentiation of WM tumor B-cells by FCM, we evidenced a CD138 expression continuum between monotypic B-cells and PCs. This pattern remained absent in control samples and was significantly associated with higher IgM peaks (p = 6.10-5 ) and MYD88 mutations (p = 10-3 ) in both WM and MGUS cases. CONCLUSIONS FCM exploration of both B-cells and PC led to identify a CD138 expression continuum as an objective marker of ongoing PC differentiation of WM tumor cells and was strongly associated with increased IgM peak levels and MYD88 mutations. This approach could contribute to place FCM at the forefront of WM diagnosis.
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Affiliation(s)
- Mylene Gayet
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France
| | - Vincent Leymarie
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France
| | - Paco Derouault
- Department of Biochemistry and Molecular Biology, University Hospital Dupuytren, Limoges, France
| | - Estelle Guérin
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France.,UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France
| | - Julien Vaidié
- Clinical Hematology and Cellular Therapy, University Hospital Dupuytren, Limoges, France
| | - Virginie Pascal
- UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France.,Department of Immunology and Immunogenetics, University Hospital Dupuytren, Limoges, France
| | - Mélanie Boulin
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France
| | - Nataliya Dmytruk
- Clinical Hematology and Cellular Therapy, University Hospital Dupuytren, Limoges, France
| | - Jasmine Chauzeix
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France.,UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France
| | - Franck Trimoreau
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France
| | - Nathalie Gachard
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France.,UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France
| | - Jean Feuillard
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France.,UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France
| | - David Rizzo
- Biological Hematology Department, University Hospital Dupuytren, Limoges, France.,UMR CNRS 7276/INSERM 1262 - CRIBL, Faculty of Medicine, Limoges, France
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Martínez-Girón R, Martínez-Torre S. Morphology quiz: Pericardial effusion as first manifestation of malignancy. Cytopathology 2018; 29:309-310. [PMID: 29732625 DOI: 10.1111/cyt.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- R Martínez-Girón
- INCLÍNICA Foundation for Clinical, Pneumological and Carcinogenic Research, Oviedo, Spain
| | - S Martínez-Torre
- Departament of Family and Community Medicine, Hospital Universitario La Paz, Madrid, Spain
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