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ORIGINAL ARTICLE
Year : 2019  |  Volume : 44  |  Issue : 4  |  Page : 227-231

Sensitivity of flow cytometry immunophenotyping compared with bone marrow morphology in diagnosis of multiple myeloma


1 Demonstrator at Clinical Pathology Department of South Egypt Cancer Institute, Assiut University, Assiut, Egypt
2 Lecturer at Clinical Pathology Department of South Egypt Cancer Institute, Assiut University, Assiut, Egypt
3 Professor at Clinical Pathology Department of the Faculty of Medicine, Assiut University, Assiut, Egypt
4 Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
5 Professor at Clinical Pathology Department of South Egypt Cancer Institute, Assiut University, Egypt

Correspondence Address:
Eman H Ahmed
As. Professor Clinical Pathology/South Egypt Cancer Institute
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejh.ejh_42_19

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Background The diagnosis of multiple myeloma (MM) is challenging, as it is based on several factors, including serum and urine protein electrophoresis, immunofixation, bone marrow (BM) aspirate, and biopsy, in addition to immunophenotyping. Moreover, quantification of BM plasma cells (PCs) by conventional morphology is a mandatory test for the diagnosis and response assessment in MM. One alternative would be to use multiparameter flow cytometry immunophenotyping to quantify BMPCs, although this is currently still limited to research studies and the differential diagnosis of unusual cases. Aim The aim was to determine the diagnostic sensitivity of flow cytometry in the detection of abnormal PCs in BM specimens of MM compared with BM morphology. Patients and methods We retrospectively analyzed bone marrow aspiration (BMA), bone marrow biopsy (BMB), and immunophenotypic reports of 50 newly diagnosed patients with MM. Patients’ data were collected and analyzed. Results BMA of 43 (86%) patients showed PCs greater than or equal to 10%; BMB of 35 of them showed PCs greater than or equal to 10%, and five patients were with poor BMB quality. The sensitivity of BMB in detection of PCs was 90% and 86% for BMA. Concerning immunophenotyping, the gate of mononuclear cells was in the range of 4–88%; those gated cells were 100% positive for CD138 and CD38. CD56 was positive in 84% whereas CD19 was negative in 96%. Overall, 46% were κ restricted and 54% were λ restricted, with 100% sensitivity to malignant PCs. Conclusion Unlike morphologic and histologic studies, FC is not dependable for providing quantitative information about MM but provides qualitative information for assessing the immunophenotype and light chain clonality of PCs.


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