Open AccessClinical, Immunophenotypic, and Genetic Characterization of Small Lymphocyte–Like Plasma Cell Myeloma
Author(s) -
Amy Heerema-McKenney,
James Waldron,
Steven D. Hughes,
Fenghuang Zhan,
J. Scott Sawyer,
Bart Barlogie,
John D. Shaughnessy
Publication year - 2010
Publication title -
american journal of clinical pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.859
H-Index - 128
eISSN - 1943-7722
pISSN - 0002-9173
DOI - 10.1309/ajcpus3prrt5zxvs
Subject(s) - lymphocyte , cd20 , plasma cell myeloma , plasma cell , bone marrow , lymphoma , multiple myeloma , pathology , biology , cd38 , immunophenotyping , plasma cell leukemia , gene expression profiling , flow cytometry , cancer research , cd34 , immunology , medicine , gene expression , gene , genetics , stem cell
We reviewed bone marrow studies from 351 multiple myeloma (MM) cases, selecting 12 cases (3.4%) with predominantly small lymphocyte-like morphologic features resembling B-cell lymphoma, and correlated their genetic and clinical features. All exhibited a diffuse interstitial pattern of marrow involvement. Small lymphocyte-like plasma cells were all CD45- with bright CD38 and CD138 expression and CD20 expression in 5 cases. No case had an increase in bone marrow B lymphocytes by flow cytometry. Of 12 cases, 9 were classified as the CD-2 molecular class by gene expression profiling (GEP). The 29 CD-2 class cases with (n = 9) and without (n = 20) small lymphocyte-like features could not be discerned from one another using global GEP. Event-free, but not overall, survival was significantly better in cases with small lymphocyte-like features among those sharing the CD-2 subtype. Small lymphocyte-like MM is a rare, morphologically challenging variant distinguished from B-cell lymphoma by lack of CD45 and presence of CD138 and the clinical presentation of MM. Most cases share a common GEP signature dominated by hyperexpression of cyclin D1 or cyclin D3 genes, with increased expression of the B-cell genes CD20 and VPREB3.