Evdoxia Gounari1, Vasiliki Tsavdaridou1, Triantafyllia Koletsa2, Androula Nikolaidou3, Georgia Kaiafa4, Maria Papaioannou5, Ioannis Kostopoulos2, Lemonia Skoura1. 1. Immunology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece. 2. Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3. Haematology Department, Microbiology Laboratory, AHEPA University Hospital, Thessaloniki, Greece. 4. Haematology Department, First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. 5. Haematology Department, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract
BACKGROUND: Circulating neoplastic plasma cells (PCs) are a common feature between classical plasma cell myeloma (PCM) and its aggressive variant, plasma cell leukemia (PCL), with their early suspicion and detection being of clinical importance for prognostic and diagnostic purposes. METHODS: Morphological and flow cytometric enumeration and characterization of peripheral blood (PB) neoplastic PCs were performed in 3 PCM patients after complete blood count (CBC) evaluation. RESULTS: Early suspicion of circulating PCs by initial CBC scatter plots and monocytosis led to morphological enumeration of PCs, with low level of concordance between morphologists. Flow cytometric PB analysis permitted accurate quantification and characterization of circulating clonal PCs. CONCLUSIONS: CBC findings can prompt early suspicion of circulating PCs in PCM patients leading to early and accurate flow cytometric analysis of clonal PCs in addition to morphological PB evaluation. The suggested combined approach proved to be most important in the PCL case with discordant morphological evaluations and marginal PC numbers according to current criteria.
BACKGROUND: Circulating neoplastic plasma cells (PCs) are a common feature between classical plasma cell myeloma (PCM) and its aggressive variant, plasma cell leukemia (PCL), with their early suspicion and detection being of clinical importance for prognostic and diagnostic purposes. METHODS: Morphological and flow cytometric enumeration and characterization of peripheral blood (PB) neoplastic PCs were performed in 3 PCM patients after complete blood count (CBC) evaluation. RESULTS: Early suspicion of circulating PCs by initial CBC scatter plots and monocytosis led to morphological enumeration of PCs, with low level of concordance between morphologists. Flow cytometric PB analysis permitted accurate quantification and characterization of circulating clonal PCs. CONCLUSIONS: CBC findings can prompt early suspicion of circulating PCs in PCM patients leading to early and accurate flow cytometric analysis of clonal PCs in addition to morphological PB evaluation. The suggested combined approach proved to be most important in the PCL case with discordant morphological evaluations and marginal PC numbers according to current criteria.