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Medicina & Laboratorio

2017, Number 09-10

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Medicina & Laboratorio 2017; 23 (09-10)

Morphology and immunophenotype of plasma cells in multiple myeloma

Rincón-Vásquez NJ, Jaramillo-Arbeláez PE, Llanos-Albornoz CM

Language: Spanish
References: 79
Page: 443-458
PDF size: 765.10 Kb.


ABSTRACT

The advance in the knowledge of the pathophysiology of multiple myeloma has allowed the approach to the understanding of its heterogeneity in terms of clinical, cytomorphological, phenotypic, biochemical, genetic and molecular behavior, contributing to the development of new treatments and the establishment of models that point to a chronicity of the disease. The morphological changes of the plasma cell in the multiple myeloma indicate mainly to alterations at the nucleus level, which orient to the differentiation between reactive cells and clonal cells; also that their immaturity is of poor prognosis. Likewise, the expression of certain monoclonal markers, and the absence of others, detected by flow cytometry, immunophenotypically classify the neoplastic cells of multiple myeloma, which allows to considering this tool as one of the best in the diagnosis and management of minimal residual disease. In this review it is intend to emphasize the importance of identifying the morphological change that occur in plasma cells and their relationship with the immunophenotypics characteristics in neoplasia that have an important prognostic association with the multiple myeloma development.


REFERENCES

  1. Gorczyca W. Plasma cell neoplasms. Atlas of Differential Diagnosis in Neoplastic Hematopathology (ed 3a). Boca Ratón, Florida, Estados Unidos: CRC Press; 2014: 359- 382.

  2. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (ed 4a). Lyon, Francia: International Agency for Research on Cancer; 2008.

  3. San Miguel JF, Gutierrez NC, Mateo G, Orfao A. Conventional diagnostics in multiple myeloma. Eur J Cancer 2006; 42: 1510-1519.

  4. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-2390.

  5. Ramasamy K, Lonial S. Fast Facts: Multiple Myeloma and Plasma Cell Dyscrasias. Oxford, Reino Unido: Health Press Limited; 2015.

  6. Rajkumar SV. Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol 2016; 91: 719-734.

  7. Erikci AA, Ozturk A, Tekgunduz E, Sayan O. Acute myeloid leukemia complicating multiple myeloma: a case successfully treated with etoposide, thioguanine, and cytarabine. Clin Lymphoma Myeloma 2009; 9: E14-15.

  8. Luca DC, Almanaseer IY. Simultaneous presentation of multiple myeloma and acute monocytic leukemia. Arch Pathol Lab Med 2003; 127: 1506-1508.

  9. Mailankody S, Pfeiffer RM, Kristinsson SY, Korde N, Bjorkholm M, Goldin LR, et al. Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS). Blood 2011; 118: 4086-4092.

  10. Dincol G, Nalcaci M, Dogan O, Aktan M, Kucukkaya R, Agan M, et al. Coexistence of chronic neutrophilic leukemia with multiple myeloma. Leuk Lymphoma 2002; 43: 649-651.

  11. Cid Ruzafa J, Merinopoulou E, Baggaley RF, Leighton P, Werther W, Felici D, et al. Patient population with multiple myeloma and transitions across different lines of therapy in the USA: an epidemiologic model. Pharmacoepidemiol Drug Saf 2016; 25: 871-879.

  12. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin 2003; 53: 5-26.

  13. Blade J, Kyle RA, Greipp PR. Multiple myeloma in patients younger than 30 years. Report of 10 cases and review of the literature. Arch Intern Med 1996; 156: 1463- 1468.

  14. El Mangad F EZ, El Bouchti I. Multiple Myeloma in Unusually Young Patient: A Case Report. Int J Clin Med 2014; 05: 890–893.

  15. Ramón Rodríguez LG, Agramonte Llanes O, Hernández Padrón C, Espinosa Martínez E, Losada Buchillón R, Ávila Cabrera O, et al. Mieloma múltiple y embarazo: Primer reporte de caso en Cuba. Rev Cubana Hematol Inmunol Hemoter 2010; 26: 70-75.

  16. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 2003; 78: 21-33.

  17. Rosenberg PS, Barker KA, Anderson WF. Future distribution of multiple myeloma in the United States by sex, age, and race/ethnicity. Blood 2015; 125: 410-412.

  18. Sant M, Allemani C, Tereanu C, De Angelis R, Capocaccia R, Visser O, et al. Incidence of hematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 2010; 116: 3724-3734.

  19. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66: 7-30.

  20. Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin 2016.

  21. Alvarado M, Álvarez JL, Anaya I, et al. Primer Consenso Nacional de Mieloma Múltiple por Hematólogos del ISSSTE. Rev Hematol México 2015; 16: 306–332.

  22. World Health Organization, International Agency for Research on Cancer. Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012 - Population Fact Sheets: Colombia. 2012. Disponible: http://globocan.iarc.fr/Pages/fact_sheets_population. aspx.

  23. World Health Organization, International Agency for Research on Cancer. Globocan 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012 - Online Analysis: Prediction. 2012. Disponible: http:// globocan.iarc.fr/Pages/burden_sel.aspx.

  24. Dispenzieri A. Myeloma: management of the newly diagnosed high-risk patient. Hematology Am Soc Hematol Educ Program 2016; 2016: 485-494.

  25. Heusschen R, Muller J, Duray E, Withofs N, Bolomsky A, Baron F, et al. Molecular mechanisms, current management and next generation therapy in myeloma bone disease. Leuk Lymphoma 2018; 59: 14-28.

  26. Roodman GD. Myeloma bone disease: pathogenesis and treatment. Oncology (Williston Park) 2005; 19: 983-984, 986.

  27. Shah V, Sherborne AL, Walker BA, Johnson DC, Boyle EM, Ellis S, et al. Prediction of outcome in newly diagnosed myeloma: a meta-analysis of the molecular profiles of 1905 trial patients. Leukemia 2017; 32: 102.

  28. Fonseca R, Abouzaid S, Bonafede M, Cai Q, Parikh K, Cosler L, et al. Trends in overall survival and costs of multiple myeloma, 2000–2014. Leukemia 2016; 31: 1915.

  29. Moeremans K, Annemans L. An update: health economics of managing multiple myeloma. Eur J Cancer 2006; 42: 1684-1691.

  30. Shaffer AL, Shapiro-Shelef M, Iwakoshi NN, Lee AH, Qian SB, Zhao H, et al. XBP1, downstream of Blimp-1, expands the secretory apparatus and other organelles, and increases protein synthesis in plasma cell differentiation. Immunity 2004; 21: 81-93.

  31. Zandi S, Mansson R, Tsapogas P, Zetterblad J, Bryder D, Sigvardsson M. EBF1 is essential for B-lineage priming and establishment of a transcription factor network in common lymphoid progenitors. J Immunol 2008; 181: 3364-3372.

  32. Shapiro-Shelef M, Calame K. Regulation of plasma-cell development. Nat Rev Immunol 2005; 5: 230-242.

  33. Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B. Wintrobe’s Clinical Hematology (ed 11a). Maryland, Estados Unidos: Lippincott Williams & Wilkins; 2004.

  34. Goldman L, Schafer AI. Goldman-Cecil. Tratado de Medicina Interna. Vol. 1 (ed 25a). España: Elsevier Inc.; 2017.

  35. Porwit A, McCullough J, Erber W. Blood and bone marrow pathology: Churchill Livingstone Elsevier; 2011.

  36. Miale JB. Hematología : Medicina de Laboratorio (ed 6a). España: Reverté; 1985.

  37. College of American Pathologists. 2017 Hematology, Clinical Microscopy, and Body Fluids Glossary. 2017. Disponible: http://www.cap.org/ShowProperty?node- Path=/UCMCon/Contribution%20Folders/WebContent/ pdf/hematology-glossary.pdf.

  38. Nikesitch N, Ling SC. Molecular mechanisms in multiple myeloma drug resistance. J Clin Pathol 2016; 69: 97-101.

  39. Morgan GJ, Walker BA, Davies FE. The genetic architecture of multiple myeloma. Nat Rev Cancer 2012; 12: 335- 348.

  40. Yun Z, Zhichao J, Hao Y, Ou J, Ran Y, Wen D, et al. Targeting autophagy in multiple myeloma. Leuk Res 2017; 59: 97-104.

  41. Ribourtout B, Zandecki M. Plasma cell morphology in multiple myeloma and related disorders. Morphologie 2015; 99: 38-62.

  42. Ho WK, Zantomio D. Auer rod-like inclusions in plasma cells in multiple myeloma. J Clin Pathol 2014; 67: 547- 548.

  43. Tejwani N, Tyagi S, Dass J. Multiple Auer Rod Like Inclusions in Multiple Myeloma. Indian J Hematol Blood Transfus 2017; 33: 121-122.

  44. Hutter G, Nowak D, Blau IW, Thiel E. Auer rod-like intracytoplasmic inclusions in multiple myeloma. A case report and review of the literature. Int J Lab Hematol 2009; 31: 236-240.

  45. Zhu L, An L, Zhang XY, Ren XR, Song JW. Peroxidase-positive Auer bodies in plasma cells in multiple myeloma: a case report. Int J Clin Exp Pathol 2015; 8: 15301-15306.

  46. Eyre TA, Littlewood TJ, Bain BJ. Dutcher bodies: cytoplasmic inclusions within the nucleus. Br J Haematol 2014; 166: 946-947.

  47. Ortíz-Hidalgo C. De las células plasmáticas al mieloma múltiple. Una breve perspectiva histórica. Patol Rev Latinoam 2011; 49: 120-131.

  48. Pantanowitz L, Tranovich V, Ballesteros E. Flaming plasma cells. Arch Pathol Lab Med 2001; 125: 1394-1395.

  49. Seili-Bekafigo I, Valkovic T, Babarovic E, Duletic-Nacinovic A, Jonjic N. Myeloma cell morphology and morphometry in correlation with clinical stages and survival. Diagn Cytopathol 2013; 41: 947-954.

  50. You E, Cho SY, Yang JJ, Lee HJ, Lee WI, Yoon HJ, et al. Plasma cell neoplasms showing multilobulated nuclei. Acta Haematol 2013; 130: 98-100.

  51. Ghevaert C, Fournier M, Bernardi F, Genevieve F, Pouyol F, Zandecki M. Non-secretory multiple myeloma with multinucleated giant plasma cells. Leuk Lymphoma 1997; 27: 185-189.

  52. Subramanian R, Basu D, Dutta TK. Prognostic significance of bone marrow histology in multiple myeloma. Indian J Cancer 2009; 46: 40-45.

  53. Bartl R, Frisch B, Fateh-Moghadam A, Kettner G, Jaeger K, Sommerfeld W. Histologic classification and staging of multiple myeloma. A retrospective and prospective study of 674 cases. Am J Clin Pathol 1987; 87: 342-355.

  54. Paule B, Quillard J, Bisson M, Kahn MF, Massias P. Prognostic significance of plasma cell morphology in multiple myeloma. Nouv Rev Fr Hematol 1988; 30: 209-212.

  55. Bartl R, Frisch B, Burkhardt R, Fateh-Moghadam A, Mahl G, Gierster P, et al. Bone marrow histology in myeloma: its importance in diagnosis, prognosis, classification and staging. Br J Haematol 1982; 51: 361-375.

  56. Greipp PR, Raymond NM, Kyle RA, O’Fallon WM. Multiple myeloma: significance of plasmablastic subtype in morphological classification. Blood 1985; 65: 305-310.

  57. De los Reyes N, Monserrat J, Martínez MV, Álvarez MR, Minguela A. Utilidad de la Citometría de Flujo en el diagnóstico y pronóstico del Mieloma Múltiple. Cuadernos de Hematología 2010: 1-12.

  58. Flores-Montero J, de Tute R, Paiva B, Perez JJ, Bottcher S, Wind H, et al. Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma. Cytometry B Clin Cytom 2016; 90: 61-72.

  59. Karthick R M, Kovarova L, Hajek R. Review of phenotypic markers used in flow cytometric analysis of MGUS and MM, and applicability of flow cytometry in other plasma cell disorders. Br J Haematol 2010; 149: 334-351.

  60. Zandecki M, Facon T, Bernardi F, Izydorczyk V, Dupond L, Francois M, et al. CD19 and immunophenotype of bone marrow plasma cells in monoclonal gammopathy of undetermined significance. J Clin Pathol 1995; 48: 548-552.

  61. Lin P, Owens R, Tricot G, Wilson CS. Flow cytometric immunophenotypic analysis of 306 cases of multiple myeloma. Am J Clin Pathol 2004; 121: 482-488.

  62. An G, Xu Y, Shi L, Zou D, Deng S, Sui W, et al. t(11;14) multiple myeloma: a subtype associated with distinct immunological features, immunophenotypic characteristics but divergent outcome. Leuk Res 2013; 37: 1251-1257.

  63. Olteanu H, Wang HY, Chen W, McKenna RW, Karandikar NJ. Immunophenotypic studies of monoclonal gammopathy of undetermined significance. BMC Clin Pathol 2008; 8: 13.

  64. Nair JR, Carlson LM, Koorella C, Rozanski CH, Byrne GE, Bergsagel PL, et al. CD28 expressed on malignant plasma cells induces a prosurvival and immunosuppressive microenvironment. J Immunol 2011; 187: 1243-1253.

  65. Robillard N, Wuillème S, Moreau P, Béné MC. Immunophenotype of Normal and Myelomatous Plasma-Cell Subsets. Front Immunol 2014; 5: 137.

  66. Shim H, Ha JH, Lee H, Sohn JY, Kim HJ, Eom HS, et al. Expression of myeloid antigen in neoplastic plasma cells is related to adverse prognosis in patients with multiple myeloma. Biomed Res Int 2014; 2014: 893243.

  67. Rawstron AC, Orfao A, Beksac M, Bezdickova L, Brooimans RA, Bumbea H, et al. Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders. Haematologica 2008; 93: 431-438.

  68. Davids MS, Murali MR, Kuter DJ. Serum free light chain analysis. Am J Hematol 2010; 85: 787-790.

  69. The International Myeloma Working Group, Kyle RA, Child J, Anderson K, Barlogie B, Bataille R, et al. Criteria for the classification monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol 2003; 121: 749-757.

  70. Durie BG, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer 1975; 36: 842-854.

  71. Conté L G, Figueroa M G, Lois V V, Cabrera C ME, León R A, García L H, et al. Valor pronóstico del nuevo sistema de etapificación internacional en mieloma múltiple: Comparación con el sistema de Durie-Salmon. Rev Méd Chile 2008; 136: 7-12.

  72. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014; 15: e538-548.

  73. Sociedad Argentina de Hematología. Guías de diagnóstico y tratamiento Clin Chiest Med 2015; 20: 335-337.

  74. Sonneveld P, Avet-Loiseau H, Lonial S, Usmani S, Siegel D, Anderson KC, et al. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood 2016; 127: 2955- 2962.

  75. Kaufman GP, Gertz MA, Dispenzieri A, Lacy MQ, Buadi FK, Dingli D, et al. Impact of cytogenetic classification on outcomes following early high-dose therapy in multiple myeloma. Leukemia 2016; 30: 633-639.

  76. Moreau P, San Miguel J, Sonneveld P, Mateos MV, Zamagni E, Avet-Loiseau H, et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol 2017; 28: iv52-iv61.

  77. Cogbill CH, Spears MD, Vantuinen P, Harrington AM, Olteanu H, Kroft SH. Morphologic and cytogenetic variables affect the flow cytometric recovery of plasma cell myeloma cells in bone marrow aspirates. Int J Lab Hematol 2015; 37: 797-808.

  78. Kyle RA, Rajkumar SV. Multiple myeloma. Blood 2008; 111: 2962-2972.

  79. Rajkumar SV. Updated Diagnostic Criteria and Staging System for Multiple Myeloma. Am Soc Clin Oncol Educ Book 2016; 35: e418-423.




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