Immunophenotypic assessment of clonal plasma cells and B-cells in bone marrow and blood in the diagnostic classification of early stage monoclonal gammopathies: an iSTOPMM study

Monoclonal gammopathy of undetermined significance (MGUS) is the earliest discernible stage of multiple myeloma (MM) and Waldenström’s macroglobulinemia (WM). Early diagnosis of MG may be compromised by the low-level infiltration, undetectable to low-sensitive methodologies. Here, we investigated th...

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Published in:Blood cancer journal (New York) 2023-12, Vol.13 (1), p.182-182, Article 182
Main Authors: Pérez-Escurza, Oihane, Flores-Montero, Juan, Óskarsson, Jón Þórir, Sanoja-Flores, Luzalba, del Pozo, Julio, Lecrevisse, Quentin, Martín, Silvia, Reed, Elín Ruth, Hákonardóttir, Guðlaug Katrín, Harding, Stephen, Þorsteinsdóttir, Sigrún, Rögnvaldsson, Sæmundur, Love, Thorvardur Jon, Durie, Brian, Kristinsson, Sigurður Yngvi, Orfao, Alberto
Format: Article
Language:English
Subjects:
13/31
692/699/1541/1990/804
692/699/67/1990/804
Biomedical and Life Sciences
Biomedicine
Bone marrow
Cancer Research
Classification
Hematology
Lymphocytes
Oncology
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Summary:Monoclonal gammopathy of undetermined significance (MGUS) is the earliest discernible stage of multiple myeloma (MM) and Waldenström’s macroglobulinemia (WM). Early diagnosis of MG may be compromised by the low-level infiltration, undetectable to low-sensitive methodologies. Here, we investigated the prevalence and immunophenotypic profile of clonal (c) plasma cells (PC) and/or cB-lymphocytes in bone marrow (BM) and blood of subjects with a serum M-component from the iSTOPMM program, using high-sensitive next-generation flow cytometry (NGF), and its utility in the diagnostic classification of early-stage MG. We studied 164 paired BM and blood samples from 82 subjects, focusing the analysis on: 55 MGUS, 12 smoldering MM (SMM) and 8 smoldering WM (SWM). cPC were detected in 84% of the BM samples and cB-lymphocytes in 45%, coexisting in 39% of cases. In 29% of patients, the phenotypic features of cPC and/or cB-lymphocytes allowed a more accurate disease classification, including: 19/55 (35%) MGUS, 1/12 (8%) SMM and 2/8 (25%) SWM. Blood samples were informative in 49% of the BM-positive cases. We demonstrated the utility of NGF for a more accurate diagnostic classification of early-stage MG.
ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-023-00944-1