Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis

Monoclonal gammopathy of uncertain significance (MGUS) and smoldering multiple myeloma (SMM) are plasma cell disorders with a risk of progression of approximately 1% and 10% per year, respectively. We have previously shown that the proportion of bone marrow (BM) aberrant plasma cells (aPCs) within the BMPC compartment (aPC/BMPC) as assessed by flow cytometry (FC) contributes to differential diagnosis between MGUS and multiple myloma (MM). The goal of the present study was to investigate this parameter as a marker for risk of progression in MGUS (n = 407) and SMM (n = 93). Patients with a marked predominance of aPCs/BMPC (≥ 95%) at diagnosis displayed a significantly higher risk of progression both in MGUS and SMM (P< .001). Multivariate analysis for progression-free survival (PFS) selected the percentage aPC/BMPC (≥ 95%) as the most important independent variable, together with DNA aneuploidy and immunoparesis, for MGUS and SMM, respectively. Using these independent variables, we have identified 3 risk categories in MGUS (PFS at 5 years of 2%, 10%, and 46%, respectively; P< .001) and SMM patients (PFS at 5 years of 4%, 46%, and 72%, respectively; P < .001). Our results show that multiparameter FC evaluation of BMPC at diagnosis is a valuable tool that could help to individualize the follow-up strategy for MGUS and SMM patients.

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Expression of CD56/Neural Cell Adhesion Molecule Correlates with the Presence of Lytic Bone Lesions in Multiple Myeloma and Distinguishes Myeloma from Monoclonal Gammopathy of Undetermined Significance and Lymphomas with Plasmacytoid Differentiation

American Journal Of Pathology ◽

10.1016/s0002-9440(10)62556-4 ◽

2002 ◽

Vol 160 (4) ◽

pp. 1293-1299 ◽

Cited By ~ 116

Author(s):

Scott A. Ely ◽

Daniel M. Knowles

Keyword(s):

Multiple Myeloma ◽

Cell Adhesion ◽

Adhesion Molecule ◽

Monoclonal Gammopathy ◽

Cell Adhesion Molecule ◽

Neural Cell Adhesion Molecule ◽

Bone Lesions ◽

Neural Cell Adhesion ◽

Lytic Bone Lesions ◽

Undetermined Significance

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Multiple myeloma and related conditions

10.1093/med/9780199568741.003.0290 ◽

2018 ◽

Author(s):

Graham Collins ◽

Chris Bunch

Keyword(s):

Multiple Myeloma ◽

Bone Marrow ◽

Monoclonal Gammopathy ◽

Plasma Cells ◽

Cell Clone ◽

Bone Marrow Failure ◽

Organ Damage ◽

End Organ Damage ◽

Clonal Proliferation ◽

Uncertain Significance

Multiple myeloma is a cancerous disorder of the bone marrow and arises from a clonal proliferation of plasma cells, resulting in end-organ damage (e.g. renal failure, hypercalcaemia, bone disease, and bone marrow failure). When a plasma cell clone is only detected in one site (either bony or soft tissue), it is termed a plasmacytoma. Monoclonal gammopathy of uncertain significance is also a clonal proliferation of plasma cells but, by definition, does not result in end-organ damage. This chapter addresses the diagnosis and management of multiple myeloma.

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Multiple Myeloma with Suspected Non-Secretory Type

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v27i1.1575 ◽

2020 ◽

Vol 27 (1) ◽

Author(s):

Annisa Ginar Indrarsi ◽

Usi Sukorini

Keyword(s):

Multiple Myeloma ◽

Bone Marrow ◽

Monoclonal Gammopathy ◽

Plasma Cells ◽

Immunoglobulin A ◽

Protein Electrophoresis ◽

Palpebral Conjunctiva ◽

General Weakness ◽

M Spike ◽

G Ratio

Multiple Myeloma (MM) is a hematological malignancy characterized by clonal plasma cell in bone marrow that produceabnormal globulin, which resulted in monoclonal gammopathy. Multiple Myeloma Non-Secretory (MMNS) is a very rareform of multiple myeloma with monoclonal plasmocytic proliferation in bone marrow supported by clinical manifestationand radiological findings. However, plasma cells fail to secrete immunoglobulin. A 44-year-old female came to SardjitoGeneral Hospital with main complaints of weakness and back pain. General weakness and pale palpebral conjunctiva were6 observed (+/+), liver and spleen were not palpable. Blood test results were as follows: Hb 3.0 g/dL, RBC 1.07 x 10 / μL, WBC3 3 562 x 10 /μL, PLT 114 x 10 /μL, A/G ratio 1.07, BUN 51.5 mg/dL, creatinine 4.62 mg/dL, and calcium 3.1 mmol/L. Skeletalsurvey suggested a multiple osteolytic. Protein electrophoresis revealed hypogammaglobulinemia with no M-spike. Therewere 66% of plasma cells in bone marrow. Patient was diagnosed by MMNS. Diagnosis MMNS can be established if clonalplasmacytes is accompanied with renal insufficiency and hypercalcemia. However, monoclonal gammopathy was not foundin serum protein electrophoresis. A case reported of 44-year-old female diagnosed as MMNS with 'punched out' multipleosteolytic, increased plasma cells in bone marrow without evidence of paraprotein in circulation proved by low A/G ratio andnegative M-spike.

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