An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa-lambda ratios of CD38-gated CD138 cellsReport as inadecuate

An approach for diagnosing plasma cell myeloma by three-color flow cytometry based on kappa-lambda ratios of CD38-gated CD138 cells - Download this document for free, or read online. Document in PDF available to download.

Diagnostic Pathology

, 7:131

First Online: 28 September 2012Received: 26 July 2012Accepted: 24 September 2012


BackgroundWorld Health Organization WHO criteria are commonly used to diagnose plasma cell myeloma PCM; however, these criteria are complex and require several laboratory parameters. For differentiating reactive plasmacytosis from clonal plasma cell PC neoplasms such as PCM, it is important to accurately determine the expression of cytoplasmic immunoglobulin light chains.

MethodsWe retrospectively analyzed the records of 27 selected patients with PCM who underwent bone biopsies for confirmative diagnosis according to WHO criteria. Twenty-three controls were also investigated. In the present study, all the samples were analyzed using flow cytometry FC in the side scatter vs. CD38 histogram mode, and the CD38-gated PC population was identified. Bivariate histograms of CD138-kappa and CD138-lambda were assessed, and the ratios of dual-positive cells to the CD138 PC population were calculated. The kappa-lambda ratio was defined as the ratio of CD138-kappa to CD138-lambda.

ResultsPCM cells were distinguished from normal PCs using cutoff levels between 0.76 and 1.5, at a sensitivity of 96.3% and specificity of 95.7%.

ConclusionsThree-color FC analysis is simple to perform and inexpensive, with clinically relevant data obtained soon after the completion of FC measurements. The detection of the cytoplasmic kappa-lambda ratio of CD38-gated CD138 PCs may be a useful tool in the diagnosis of PCM. To the best of our knowledge, this report represents the first diagnostic assessment of the cytoplasmic kappa-lambda ratio in CD38-gated CD138+ PCs using FC analysis. This method may help in more simple, efficient, rapid, and accurate diagnosis of PCM.

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KeywordsPlasma cell myeloma Diagnosis kappa-lambda ratio CD138 CD38 AbbreviationsPCMPlasma cell myeloma

BMBone marrow

WHOWorld Health Organization

PCPlasma cell

FCFlow cytometry

FSCForward scatter

SSCSide scatter

PBSPhosphate-buffered saline


CIgCytoplasmic Ig

LCLight chain

PC5Phycoerythrin cyanine 5.1

FITCFluorescein isothiocyanate

SDStandard deviation.

Electronic supplementary materialThe online version of this article doi:10.1186-1746-1596-7-131 contains supplementary material, which is available to authorized users.

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Author: Shoko Nakayama - Taiji Yokote - Yuji Hirata - Kazuki Iwaki - Toshikazu Akioka - Takuji Miyoshi - Ayami Takayama - Uta Nish


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