RE: Antibodies for malignant plasma cells

From: Anja Porwit (Anja.Porwit@ks.se)
Date: Fri Dec 07 2001 - 03:55:21 EST


I agree with Leonel. In cases with plasma cell count in the smear is
approx. 10% and there are no solid infiltrates in the biopsy, the flow
gives an information if there are only pathological PC present or if there
still is a normal PC background. This information can be valuable for the
hematologist.

Kind regards
Anna Porwit

At 09:26 2001-12-06 -0500, you wrote:
>
>
>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
>
>
>
>
Anna Porwit
Hematopathology Lab.
Department of Pathology, Radiumhemmet
Karolinska Hospital, 171 76 Stockholm, Sweden
Anja.Porwit@ks.se
tel.:+46-851774518
fax.:+46-851775843



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