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Abstract: Although multiparameter flow cytometry (MFC) has demonstrated clinical relevance in monoclonal gammopathy of undetermined significance (MGUS)/myeloma, immunophenotypic studies on the full spectrum of Waldenström?s Macroglobulinemia (WM) remain scanty. Herein, a comprehensive MFC analysis on bone marrow samples from 244 newly diagnosed patients with an immunoglobulin M (IgM) monoclonal protein was performed, including 67 IgM-MGUS, 77 smoldering and 100 symptomatic WM. Our results show a progressive increase on the number and light-chain-isotype-positive B-cells from IgM-MGUS to smoldering and symptomatic WM (P<.001), with only 1% of IgM-MGUS patients showing >10% B cells or 100% light-chain-isotype-positive B-cells (P<.001). Complete light-chain restriction of the B-cell compartment was an independent prognostic factor for time-to progression in smoldering WM (median 26 months; HR: 19.8, P=0.001) and overall survival in symptomatic WM (median 44 months; HR: 2.6, P=0.004). The progressive accumulation of light-chain-isotype-positive B-cells accompanied the emergence of a characteristic Waldenstrom?s phenotype (CD22+dim/CD25+/CD27+/IgM+) that differed from other B-NHL by negative expression of CD5, CD10, CD11c or CD103. In contrast to myeloma, light-chain-isotype-positive plasma cells in IgM monoclonal gammopathies show otherwise normal antigenic expression. Our results highlight the potential value of MFC immunophenotyping for the characterization of the Waldenström?s clone, as well as for the differential diagnosis, risk of progression and survival in WM.
Fuente: Leukemia, 2014, 28(1), 166-173
Editorial: Nature Publishing Group
Año de publicación: 2014
Tipo de publicación: Artículo de Revista
DOI: 10.1038/leu.2013.124
ISSN: 0887-6924,1476-5551
Url de la publicación: https://doi.org/10.1038/leu.2013.124
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PAIVA, BRUNO
MONTES, MARÍA CARMEN
GARCÍA-SANZ, RAMÓN
ENRIQUE MARIA OCIO SAN MIGUEL
ALONSO, JUAN MANUEL
DE LAS HERAS, NATALIA
ESCALANTE, F. CÁRDENAS
CUELLO, REBECA
DE COCA, ALFONSO GARCÍA
GALENDE, JOSEFINA
HERNÁNDEZ, JOSÉ MARIANO
SIERRA, MAGDALENA
MARTÍN GARCÍA-SANCHO, ALEJANDRO PÉREZ
PARDAL, EMILIA
BÁREZ, ABELARDO
ALONSO, JOSÉ MARÍA
SUAREZ, LISBETT
GONZÁLEZ-LÓPEZ, TOMÁS JOSÉ
PEREZ, JOSÉ JUAN
ORFAO, ALBERTO
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