Monoclonal gammopathy of undetermined significance (MGUS) is the earliest discernible stage of multiple myeloma (MM) and Waldenström’s macroglobulinemia (WM). Early diagnosis of MG may be compromised by the low-level infiltration, undetectable to low-sensitive methodologies. Here, we investigated the prevalence and immunophenotypic profile of clonal (c) plasma cells (PC) and/or cB-lymphocytes in bone marrow (BM) and blood of subjects with a serum M-component from the iSTOPMM program, using high-sensitive next-generation flow cytometry (NGF), and its utility in the diagnostic classification of early-stage MG. We studied 164 paired BM and blood samples from 82 subjects, focusing the analysis on: 55 MGUS, 12 smoldering MM (SMM) and 8 smoldering WM (SWM). cPC were detected in 84% of the BM samples and cB-lymphocytes in 45%, coexisting in 39% of cases. In 29% of patients, the phenotypic features of cPC and/or cB-lymphocytes allowed a more accurate disease classification, including: 19/55 (35%) MGUS, 1/12 (8%) SMM and 2/8 (25%) SWM. Blood samples were informative in 49% of the BM-positive cases. We demonstrated the utility of NGF for a more accurate diagnostic classification of early-stage MG.
意义未明单克隆丙种球蛋白病（MGUS）是多发性骨髓瘤（MM）和华氏巨球蛋白血症（WM）可识别的最早阶段。由于肿瘤细胞浸润水平较低，且传统低灵敏度检测方法难以检出，MG的早期诊断可能受到影响。本研究利用iSTOPMM项目中伴有血清M蛋白成分的受试者样本，通过高灵敏度新一代流式细胞术（NGF）检测骨髓和血液中克隆性浆细胞和/或克隆性B淋巴细胞的流行情况与免疫表型特征，并探讨其在早期MG诊断分型中的应用价值。我们分析了来自82名受试者的164组配对骨髓与血液样本，重点关注：55例MGUS、12例冒烟型多发性骨髓瘤（SMM）和8例冒烟型华氏巨球蛋白血症（SWM）。结果显示，84%的骨髓样本中检出克隆性浆细胞，45%检出克隆性B淋巴细胞，两者在39%的病例中同时存在。在29%的患者中，克隆性浆细胞和/或克隆性B淋巴细胞的表型特征能够实现更精确的疾病分型，包括：19/55例（35%）MGUS、1/12例（8%）SMM和2/8例（25%）SWM。血液样本在49%的骨髓阳性病例中具有诊断参考价值。本研究证实了NGF在早期MG精准诊断分型中的应用价值。
肿瘤(癌症)患者之家