Antibodies for malignant plasma cells

Edwards, Leonel, M.D. Leonel.Edwards at danhosp.org
Thu Dec 6 09:26:54 EST 2001



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 at 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 at 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 at dahlchase.com






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