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CASE REPORT
Year : 2015  |  Volume : 2  |  Issue : 2  |  Page : 168-174

Fluorescence in situ hybridization on enriched CD138-positive cells in plasma cell myeloma


1 Resident - PGY 4, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
2 Director Cytopathology, Associate Professor, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
3 Director, Hematology/Hematopathology/Flow Cytometry, Associate Professor, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
4 Scientific Director, Molecular & Genomic Pathology Laboratory, Thomas Jefferson University Hospital, Assistant Professor, Department of Surgery & Pathology, Thomas Jefferson University, Philadelphia, PA 19107, USA
5 Assistant Professor, Pathology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
6 Professor and chair, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
7 Director of Cytogenetics, Assistant Professor, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA

Correspondence Address:
Renu Bajaj
Director of Cytogenetics, Assistant Professor, Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.5530/ami.2015.5.0

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To validate plasma cell enrichment technique for improving the detection of cytogenetic abnormalities in the Plasma cell myeloma (PCM)/multiple myeloma (MM). We compared the abnormality detection rate for overnight unstimulated bone marrow cultures to that for the plasma cell enriched fractions obtained with the use of CD138-coated immunomagnetic beads. Average enrichment factor (EF) was 11. One or more abnormalities were detected in 90% of enriched samples vs. 65% of non-enriched samples, thus resulting in a significantly higher detection rate of total cytogenetic abnormalities in enriched plasma cells (p=0.0038). Additional findings of RB1 deletion, TP53-, 1p-, 1q+ and IGH@ rearrangement seen in the 25% of enriched samples could contribute to the altered risk in the patient. One of the three cases with plasma cells as low as 1% by morphology was positive for a residual disease marker in the enriched sample and negative in the non-enriched sample. The plasma cell enrichment technique increased the detection rate of diagnostic and prognostic markers and is a very sensitive method for detecting minimal residual disease.


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