Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders
Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders
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DOI：
10.3324/haematol.11080
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发表时间：
2008-02-29
期刊：
影响因子：
10.1
通讯作者：
Johnsen, Hans E.
中科院分区：
文献类型：
--
作者：
Rawstron, Andy C.;Orfao, Alberto;Johnsen, Hans E.
欧洲骨髓瘤网络 (EMN) 组织了两次流式细胞术研讨会。第一个旨在通过对参与实验室当前实践的基于问卷调查的审查来确定单克隆丙种球蛋白病患者流式细胞术的具体适应症和共识技术方法。第二个目标是解决突出的技术问题并制定浆细胞分析的共识方法。确定的主要临床应用是：肿瘤性浆细胞疾病与反应性浆细胞增多症的鉴别诊断；识别 MGUS 患者的进展风险并检测微小残留病。确定了一系列技术建议，包括：1) CD38、CD138 和 CD45 应全部包含在至少一个用于浆细胞识别和计数的试管中。主要门应基于 CD38 与 CD138 表达； 2) 治疗后，克隆性评估仅在与免疫表型结合检测异常细胞时才可能提供信息。流式细胞术适用于证明严格的完全缓解； 3) 为了检测异常浆细胞，最小的组合应包括 CD19 和 CD56。优选的组还包括CD20、CD117、CD28和CD27； 4) 流式细胞仪检测到的浆细胞百分比和形态之间的差异主要与样本质量有关，因此，确定后续样本中是否存在骨髓成分非常重要，特别是 MRD 阴性病例中的正常浆细胞。
The European Myeloma Network (EMN) organized two flow cytometry workshops. The first aimed to identify specific indications for flow cytometry in patients with monoclonal gammopathies, and consensus technical approaches through a questionnaire-based review of current practice in participating laboratories. The second aimed to resolve outstanding technical issues and develop a consensus approach to analysis of plasma cells. The primary clinical applications identified were: differential diagnosis of neoplastic plasma cell disorders from reactive plasmacytosis; identifying risk of progression in patients with MGUS and detecting minimal residual disease. A range of technical recommendations were identified, including: 1) CD38, CD138 and CD45 should all be included in at least one tube for plasma cell identification and enumeration. The primary gate should be based on CD38 vs. CD138 expression; 2) after treatment, clonality assessment is only likely to be informative when combined with immunophenotype to detect abnormal cells. Flow cytometry is suitable for demonstrating a stringent complete remission; 3) for detection of abnormal plasma cells, a minimal panel should include CD19 and CD56. A preferred panel would also include CD20, CD117, CD28 and CD27; 4) discrepancies between the percentage of plasma cells detected by flow cytometry and morphology are primarily related to sample quality and it is, therefore, important to determine that marrow elements are present in follow-up samples, particularly normal plasma cells in MRD negative cases.