Open AccessMultiparameter Flow Cytometry Identification of Neoplastic Subclones: A New Biomarker in Monoclonal Gammopathy of Undetermined Significance and Multiple Myeloma
Author(s) -
Fabián Tarín,
Francisco López Castaño,
Carmen GarcíaHernández,
Paola Beneit,
Hector L Sarmiento,
Pablo Manresa Manresa,
O. Alda,
B. Villarrubia,
Margarita Blanes,
Javier Bernabéu,
Carmen Amorós,
Sara Sánchez-Sánchez,
Carmen Fernández-Miñano,
Francisco de Paz,
José Juan Verdú Belmar,
Pascual Marco,
Estella Matutes
Publication year - 2018
Publication title -
acta haematologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 56
eISSN - 1421-9662
pISSN - 0001-5792
DOI - 10.1159/000493568
Subject(s) - monoclonal gammopathy of undetermined significance , multiple myeloma , flow cytometry , monoclonal gammopathy , monoclonal antibody , identification (biology) , biomarker , pathology , monoclonal , medicine , immunology , biology , antibody , genetics , botany
Multiparameter flow cytometry (MFC)-based clonality assessment is a powerful method of diagnosis and follow-up in monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM). However, the relevance of intraclonal heterogeneity in immunophenotypic studies remains poorly understood. The main objective of this work was to characterize the different immunophenotypic subclones in MGUS and MM patients and to investigate their correlation with disease stages. An 8-color MFC protocol with 17 markers was used to identify the subclones within the neoplastic compartment of 56 MGUS subjects, 151 newly diagnosed MM patients, 30 MM subjects in complete remission with detectable minimal residual disease, and 36 relapsed/refractory MM patients. Two or more clusters were observed in > 85% of MGUS subjects, 75% of stage I MM patients, and < 15% in stage III. Likewise, a significant correlation between the dominant subclone size, secondary cytogenetic features, and changes in the expression of CD27, CD44, and CD81 was detected. The loss of intraclonal equilibrium may be an important factor related with kinetics and risk of progression not well considered to date in MFC studies. The MFC strategy used in this work can provide useful biomarkers in MGUS and MM.