Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders

Introduction: Plasma cell quantification in bone marrow is important for diagnosis, prognosis, and treatment of plasma cell diseases. It can be performed by several methods such as aspiration, imprint and flow cytometry, and biopsy. Objectives: To compare plasma cell counts at diagnosis of plasma ce...

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Main Authors: Claudia Monteiro, Paulo Campregher, Denise Pasqualin, Nydia Bacal, Liliana Suganuma, Elvira Velloso
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Hematology, Transfusion and Cell Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S253113792400302X
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author Claudia Monteiro
Paulo Campregher
Denise Pasqualin
Nydia Bacal
Liliana Suganuma
Elvira Velloso
author_facet Claudia Monteiro
Paulo Campregher
Denise Pasqualin
Nydia Bacal
Liliana Suganuma
Elvira Velloso
author_sort Claudia Monteiro
collection DOAJ
description Introduction: Plasma cell quantification in bone marrow is important for diagnosis, prognosis, and treatment of plasma cell diseases. It can be performed by several methods such as aspiration, imprint and flow cytometry, and biopsy. Objectives: To compare plasma cell counts at diagnosis of plasma cell diseases using different methods. Methods: An observational study was carried out of laboratory results of adult patients with plasma cell diseases, who underwent aspiration, imprint cytology, flow cytometry (CD38, C138) and biopsy in a single institution between January 2015 and May 2021. The intraclass correlation coefficient was used to assess agreement between different methods with results stratified into three groups: <10%; 10–59% and ≥60% of infiltration. Results: Sixty-seven cases were studied: 59.7% were men with a median age of 70 (range: 32–85) years. The diagnoses were multiple myeloma in 61%, gammopathy of undetermined significance in 25.4%, smoldering myeloma in 6% and other plasma cell dyscrasias in 7.6%. Less than 10% infiltration was found in 32 (47.7%), 35 (52.2%), 44 (65.7%) and 25 (37.3%) of patients, respectively by aspiration, imprint cytology, flow cytometry and biopsy. Infiltration ≥60% was detected in 7 (10.4%), 4 (6.0%), 2 (3.0%) and 21 (31.3%) cases, respectively. There was disagreement between the results in 37 (55.2%) of patients. Of these, 28 had greater infiltration in biopsies. The concordance (Kappa index) of biopsy with aspiration, imprint and flow cytometry was 0.501, 0.408 and 0.17; of aspiration with imprint and flow cytometry, it was 0.738 and 0.541 and between imprint and flow cytometry, it was 0.573%. Conclusions: Only aspiration and imprint cytology results agreed. Biopsy showed greater infiltrations than the other methods, but aspiration, and imprint and flow cytometry provided additional data in the diagnosis and thus should also be performed.
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spelling doaj-art-667207cde18e48d2b1db068fed09aea32024-12-21T04:29:37ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-12-0146S202S207Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disordersClaudia Monteiro0Paulo Campregher1Denise Pasqualin2Nydia Bacal3Liliana Suganuma4Elvira Velloso5Correspondig author at: Hospital Israelita Albert Einstein, Av. Albert Einstein 627, São Paulo, SP CEP05652-000, Brazil.; Hospital Israelita Albert Einstein, São Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, BrazilHospital Israelita Albert Einstein, São Paulo, SP, BrazilIntroduction: Plasma cell quantification in bone marrow is important for diagnosis, prognosis, and treatment of plasma cell diseases. It can be performed by several methods such as aspiration, imprint and flow cytometry, and biopsy. Objectives: To compare plasma cell counts at diagnosis of plasma cell diseases using different methods. Methods: An observational study was carried out of laboratory results of adult patients with plasma cell diseases, who underwent aspiration, imprint cytology, flow cytometry (CD38, C138) and biopsy in a single institution between January 2015 and May 2021. The intraclass correlation coefficient was used to assess agreement between different methods with results stratified into three groups: <10%; 10–59% and ≥60% of infiltration. Results: Sixty-seven cases were studied: 59.7% were men with a median age of 70 (range: 32–85) years. The diagnoses were multiple myeloma in 61%, gammopathy of undetermined significance in 25.4%, smoldering myeloma in 6% and other plasma cell dyscrasias in 7.6%. Less than 10% infiltration was found in 32 (47.7%), 35 (52.2%), 44 (65.7%) and 25 (37.3%) of patients, respectively by aspiration, imprint cytology, flow cytometry and biopsy. Infiltration ≥60% was detected in 7 (10.4%), 4 (6.0%), 2 (3.0%) and 21 (31.3%) cases, respectively. There was disagreement between the results in 37 (55.2%) of patients. Of these, 28 had greater infiltration in biopsies. The concordance (Kappa index) of biopsy with aspiration, imprint and flow cytometry was 0.501, 0.408 and 0.17; of aspiration with imprint and flow cytometry, it was 0.738 and 0.541 and between imprint and flow cytometry, it was 0.573%. Conclusions: Only aspiration and imprint cytology results agreed. Biopsy showed greater infiltrations than the other methods, but aspiration, and imprint and flow cytometry provided additional data in the diagnosis and thus should also be performed.http://www.sciencedirect.com/science/article/pii/S253113792400302XMultiple myelomaBone marrow aspirateFlow cytometryBone marrow biopsyPlasma cell infiltration
spellingShingle Claudia Monteiro
Paulo Campregher
Denise Pasqualin
Nydia Bacal
Liliana Suganuma
Elvira Velloso
Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
Hematology, Transfusion and Cell Therapy
Multiple myeloma
Bone marrow aspirate
Flow cytometry
Bone marrow biopsy
Plasma cell infiltration
title Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
title_full Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
title_fullStr Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
title_full_unstemmed Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
title_short Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
title_sort comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders
topic Multiple myeloma
Bone marrow aspirate
Flow cytometry
Bone marrow biopsy
Plasma cell infiltration
url http://www.sciencedirect.com/science/article/pii/S253113792400302X
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