新诊断浆细胞骨髓瘤危险分层中常规核型、间期鱼和免疫表型的相关性:一项观察性研究

Q2 Medicine

Medical Journal Armed Forces India Pub Date : 2024-12-01 DOI:10.1016/j.mjafi.2023.05.001

Paresh Singhal , Gurpreet Kaur , Deepti Mutreja , Arijit Sen , J.K. Bhatia

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引用次数: 0

摘要

浆细胞骨髓瘤（PCM）是一种常见的成人血液学肿瘤，终末分化的b细胞导致单克隆浆细胞的积累。PCM是一种异质性疾病，其生存时间由年龄、分期、细胞遗传学异常和治疗反应决定，从数月到数年不等。免疫表型作为预后指标的作用有相互矛盾的证据。本研究确定了细胞遗传学异常的频率，并建立了细胞遗传学和免疫表型在新诊断的PCM风险分层中的相关性。方法对30例4年内新诊断的PCM患者进行回顾性研究。除了广泛的骨髓瘤实验室和成像资料外，还使用CD138、CD38、CD45、CD56、CD19、CD20、CD28、CD200、CD117、κ和λ光链进行多色流式细胞术。对磁分选浆细胞的t（4;14）、t（11;14）、del(13)q和del(17)p探针进行GTG条带和间期荧光原位杂交分析。结果30例骨髓瘤患者中，男性16例（53.3%），平均年龄57.23±11.90岁。del(13)q是最常见的细胞遗传学异常。cd56阳性病例与del(17)p和III期疾病的存在密切相关(p <；0.05)。CD117在疾病晚期及高危遗传因素中呈阴性表达，t(4;14) （p = 0.049）。CD28表达缺失与较高的白蛋白水平、较低的β2MG水平和缺乏高风险遗传异常相关。晚期临床分期与CD56、CD28的表达以及CD45和CD117的缺失表达相关。结论免疫表型抗原的阳性和阴性表达与PCM的高危遗传异常和晚期临床阶段有关。机构伦理委员会参考号iec /2017/230， AFMC，浦那。

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Correlation between conventional karyotype, interphase FISH and immunophenotype in risk stratification of newly diagnosed plasma cell myeloma: An observational study

Background

Plasma cell myeloma (PCM) is a common adult hematological neoplasm of terminally differentiated B-cells resulting in accumulation of monoclonal plasma cells. PCM is heterogeneous disease with survival time varies from months to years, determined by age, stage, cytogenetics abnormalities, and treatment response. There is conflicting evidence in role of immunophenotype as a prognostic indicator. This study identified frequency of cytogenetics abnormalities and established correlation between cytogenetics and immunophenotyping in risk stratification in newly diagnosed PCM.

Methods

Pilot study was undertaken on 30 newly diagnosed PCM over 4 years. Apart from extensive myeloma laboratory and imaging profile, multicolor flow cytometry using panel of CD138, CD38, CD45, CD56, CD19, CD20, CD28, CD200, CD117, κ, and λ light-chains. Karyotyping was done using GTG banding and interphase fluorescence in situ hybridization analysis on magnetically sorted plasma cells for t(4;14), t(11;14), del(13)q, and del(17)p probes.

Results

Of 30 myeloma patients, 16(53.3%) were men with mean age 57.23 ± 11.90 years. The del(13)q was commonest cytogenetics abnormality. CD56-positive cases were strongly associated with presence of del(17)p and stage III of disease (p < 0.05). Negative expression of CD117 was seen in advanced stage of disease and high-risk genetic factor, t(4;14) (p = 0.049). Absent CD28 expression was associated with higher albumin levels, lower levels of β2MG, and lack of high-risk genetic abnormalities. Advanced clinical stages were associated with expression of CD56, CD28, and absent expression of CD45 and CD117.

Conclusion

Immunophenotypic antigens positive and negative expressions are associated with high-risk genetic abnormalities and advanced clinical stages of PCM.

Institution ethic committee reference number

IEC/2017/230, AFMC, Pune.

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来源期刊

Medical Journal Armed Forces India Medicine-Medicine (all)

CiteScore

3.40

自引率

0.00%

发文量

206

期刊介绍： This journal was conceived in 1945 as the Journal of Indian Army Medical Corps. Col DR Thapar was the first Editor who published it on behalf of Lt. Gen Gordon Wilson, the then Director of Medical Services in India. Over the years the journal has achieved various milestones. Presently it is published in Vancouver style, printed on offset, and has a distribution exceeding 5000 per issue. It is published in January, April, July and October each year.