Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma

Abstract

BackgroundEstimation of plasma cell infiltrates in bone marrow aspirates (BMA) and bone marrow biopsy (BMB) is a standard method in the diagnosis and monitoring of multiple myeloma (MM). Plasma cell fraction in the bone marrow is therefore critical for the classification and optimal clinical management of patients with plasma cell dyscrasias. The aim of the study was to compare the percentage of plasma cells obtained by both methods with the patient clinical parameters and survival.MethodsThis retrospective study included BMA and BMB of 59 MM patients. The conventional differential count was determined in BMA to estimate the percentage and cytologic grade of plasma cells. The pattern of neoplastic infiltration and percentage of plasma cells were estimated on CD138 immunostained BMB slides microscopically and by computer-assisted image analysis (CIA).ResultsSignificantly higher values of plasma cell infiltrates were observed in pathologist (47.7 ± 24.8) and CIA (44.1 ± 30.6) reports in comparison with cytologist analysis (30.6 ± 17.1; P < 0.001 and P < 0.0048, respectively). BMB assessment by pathologist counting and using CIA showed strongest correlation (r = 0.8; P < 0.0001). Correlation was also observed between the pathologist and cytologist counts (r = 0.321; P = 0.015) as well as comparing the percentage of plasma cells in BMA and CIA (r = 0.27; P = 0.05). Patients with clinical stage I/II had a significantly lower CIA plasma cell count than those with clinical stage III (P = 0.008). Overall survival was shorter in patients with more than 25% of atypical plasma cell morphology estimated in BMA (P = 0.05) and a higher percentage of tumor cell infiltrates estimated by the pathologist and CIA (P = 0.0341 and P = 0.013, respectively).ConclusionStudy results suggested the combined analyses to be useful as a routine procedure to achieve more accurate and informative diagnostic data.

Multiple Myeloma: Clinico-hematological profile in a tertiary care hospital: a three years study

“…Higher percentage of Plasma cell fraction is a reliable predictor of relapse in treated MM patients and it also helps to evaluate morphological remission and minimal residual disease in MM patients. [12,13] The present study was undertakenwith the aim to analyze the clinico-hematological profile of multiple myeloma patients in IGMC Shimla, a tertiary care hospital of Himachal Pradesh.…”

Detection of 14q32 rearrangements in multiple myeloma, using simultaneous FISH analysis combined with immunofluorescence

“…The PC fraction in the BM is therefore critical for the classification and optimal clinical management of patients with MM. 12 In the present study, FISH analysis was used with simultaneous CD138 IF on archived BM smears. The CD138 IF allows the identification and enumeration of PCs and improves the sensitivity of the FISH method, in accordance with the reports of previous studies.…”

Critical Analysis Of Bone Marrow Studies - A 5 Year Experience

“…5, Issue 1, January, 2018 Among the hematologic malignancies multiple myeloma (MM) had good positive correlation of 70.9% similar to earlier studies. 8 Also BMB provided a platform to perform IHC to assess the clonality. BMA was helpful in diagnosing 56.46% of acute leukemia diagnosed by BMB.…”