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Morphologic and cytogenetic variables affect the flow cytometric recovery of plasma cell myeloma cells in bone marrow aspirates
Author(s) -
Cogbill C. H.,
Spears M. D.,
Vantuinen P.,
Harrington A. M.,
Olteanu H.,
Kroft S. H.
Publication year - 2015
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12411
Subject(s) - immunophenotyping , flow cytometry , bone marrow , pathology , multiple myeloma , plasma cell myeloma , cd38 , bone marrow aspirate , biology , medicine , microbiology and biotechnology , immunology , cd34 , stem cell , genetics
Summary Introduction It is widely recognized that plasma cells ( PC s) are under‐represented in flow cytometry ( FC ) studies, but the causes of this phenomenon are poorly understood. We sought to study potential variables that affect PC recovery by flow cytometry ( FC ) in the analysis of plasma cell myeloma ( PCM ). Methods We retrospectively performed PC differential counts and morphologic assessment on PCM peripheral blood ( PB ) smears, bone marrow ( BM ) aspirate smears and posterythrocyte lysis cytospins. PC s were enumerated by FC , excluding erythroid events/debris, and were defined as CD 38(bright+), CD 45(dim to negative) events. PC recovery was calculated as follows: cytospin/aspirate, FC /aspirate, and FC /cytospin. Results Sixty‐four BM analyses from 42 patients showed a mean aspirate PC % of 32.9 ± 23.2%. The mean PC % decreased in both the cytospin (10.9%) and by FC (8.2%). The difference between PC % in the cytospin and by FC was statistically significant ( P < 0.03). Mature PC morphology and lower aspirate PC % had poorer recovery ( P < 0.05) but higher‐risk cytogenetics (deletions of 13q and TP 53 ) was associated with increased PC recovery. Immunophenotype, heavy chain type, and treatment did not affect PC recovery. PB specimens had superior recovery compared with BM samples. Conclusions Similar to prior reports, the greatest loss of PC in BM evaluation occurs between the aspirate and postlysis specimens; however, a small amount occurs from further processing. Additional morphologic and cytogenetic factors also appear to influence recovery in addition to overall PC %.