The same here. However in my practice environment oncologists submit a good number of bone marrow biopsies as part of the evaluation of a patient with a monoclonal spike. In these cases the plasma cell count is between 5 and 10%. It is very difficult to detect clonality by immunohistochemistry or to infer plasma cell dyscrasia by morphology alone. Flow Cytometry can definitely add significant information to these cases. Good articles are available that discuss some of the benefits. I am sure there will be more. Leonel Edwards, M.D. Medical Director Clinical Immunology, Flow Cytometry and Molecular Pathology Laboratories Department of Pathology and Laboratory Medicine Danbury Hospital 203-797-7527 -----Original Message----- From: Timothy Singleton, M.D. [mailto:tsingleton@smtpgw.beaumont.edu] Sent: Monday, December 03, 2001 5:29 PM To: Cytometry Mailing List Subject: Re: Antibodies for malignant plasma cells I have mixed feelings about performing flow cytometry for monoclonal gammopathies. These patients all have monoclonal plasma cells. Phenotyping just documents whether the clone is detectable by flow cytometry and whether there might be a phenotypic aberrancy that correlates with malignancy. Flow cytometry might not be necessary for diagnosis. >From a patient care perspective multiple myeloma is incurable, except possibly for newer modalities, such as allogeneic bone marrow transplant. Some clinical textbooks just recommend following the patients and waiting for clinical signs of disease progression (anemia, lytic bone lesions, etc.) to decide when to initiate treatment. Tim Singleton, MD Royal Oak, MI >>> "Andrea Illingworth" <dcdsflow@mint.net> 11/30/01 04:03PM >>> Dear group, What are your thoughts on the use of CD40 to differentiate normal plasma cells from myeloma cells? Currently we are using the CD45/CD56/CD38 combination but we are looking into either adding CD138 and/or CD40. Would you recommend one over the other or recommend adding both antibodies? Thank you for your input! Andrea Illingworth Dahl-Chase Flow Cytometry Bangor, Maine 04401 Andrea_Illingworth@dahlchase.com
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