Mature plasma cells as indicator of better prognosis in multiple myeloma. New methodology for the assessment of plasma cell morphology
Mature plasma cells as indicator of better prognosis in multiple myeloma. New methodology for the assessment of plasma cell morphology
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DOI：
10.1016/s0145-2126(99)00132-0
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发表时间：
1999-12-01
影响因子：
2.7
通讯作者：
Facon, T
中科院分区：
文献类型：
--
作者：
Goasguen, JE;Zandecki, M;Facon, T
在多发性骨髓瘤(MM)中，浆母细胞与预后之间的关系已经建立了近15年。但是，对这些细胞的评估并不容易进行，而且它只允许识别一小部分患者。我们使用连续标准的递进评估方法来研究浆细胞形态：核仁、染色质和核细胞比(N/C)。这三个项目的组合产生了一个子分类，其中四种细胞亚型识别93%的浆细胞，这些亚型与结果相关。这种方法的目的是基于比浆母细胞更容易识别的成熟浆细胞。这些新的细胞亚型为患者引入了一个新的分类：组1包括至少66%成熟浆细胞(P000)的患者。组2和组3的P000均低于66%，并按成熟度区分(浆I大于或等于浆II+浆母细胞)。这三组患者的区别与预后密切相关(P<；10(-4))。这些结果在来自不同机构的第二组患者身上得到了证实。总之，我们提出了一种新的评估MM浆细胞的方法，该方法基于形态标准，具有识别具有预后意义的中间(30%)患者亚群的优势。(C)1999爱思唯尔科学有限公司。保留所有权利。
The relationship between plasmablastic cells and outcome in multiple myeloma (MM) has been established for nearly 15 years. Bur the assessment of these cells is not easy to perform and it allows the identification of only a small proportion of patients. We investigated the plasma cell morphology using a progressive evaluation of consecutive criteria: nucleolus, chromatin and nuclear-cellular ratio (N/C). The combination of these three items produces a subclassification where four cellular subtypes identify 93% of the plasma cells, and these subtypes are related to the outcome. The interest of this methodology is to be based on the mature plasma cells that are easier to identify than the plasmablastic cells. These new cell subtypes introduce a new classification for patients: Group 1 includes patients with at leas than 66% mature plasma cells (P000). Both Group 2 and 3 have less than 66% P000 and are separated by their degree of maturation (Proplasma I greater than or equal to Proplasma II + plasmablastic). The distinction of these three groups of patients is highly related to the prognosis (P < 10(-4)). These results have been confirmed on a second group of patients coming from a different institution. In conclusion, we propose a new methodology for the plasma cell evaluation in MM, that is based on the morphological criteria and that has the advantage of identifying an intermediate (30%) subgroup of patients with a prognostic significance. (C) 1999 Elsevier Science Ltd. All rights reserved.