Cytogenetic abnormalities and morphological changes of bone marrow in multiple myeloma: a pathological analysis of 151 cases
10.3760/cma.j.cn112151-20200306-00178
- VernacularTitle:151例多发性骨髓瘤患者细胞遗传学异常及骨髓病理形态学分析
- Author:
Hong CHEN
1
;
Beibei ZENG
;
Yuan ZHAO
;
Yan XIE
;
Mulan JIN
Author Information
1. 首都医科大学附属北京朝阳医院病理科 100043
- Keywords:
Multiple myeloma;
Cytogenetics;
Pathology, clinical
- From:
Chinese Journal of Pathology
2020;49(11):1136-1141
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between six common cytogenetic abnormalities and bone marrow pathomorphology in multiple myeloma (MM).Methods:Bone marrow biopsy was performed on 151 newly-diagnosed MM patients. Meanwhile, myeloma cells were enriched by CD138 immunomagnetic beads, and then lq+, 13q-, 17p-, t(4;14), t (11;14), t (14;16) and other common genetic abnormalities were detected using interphase fluorescence in situ hybridization (FISH). The relationship between different genetic abnormalities and biopsy morphology was compared.Results:Of the 151 patients, 15 had extramedullary infiltration (9.9%). The rate of cytogenetic abnormalities was 76.2% (115/151), of which 1q+ accounted for 49.7% (75/151), 13q-39.1% (59/151), 17p-8.6% (13/151), t(4;14) 21.2% (32/151), t(11;14) 19.2% (29/151), and t(14;16) 2.0% (3/151). The proliferation patterns of MM plasma cells were nodular (48.3%, 73/151), interstitial (33.8%, 51/151) and diffuse (17.9%, 27/151). The morphology of plasma cells was mainly mature type (58.3%, 88/151), followed by juvenile type (20.5%, 31/151), intermediate type (15.9%, 24/151) and plasmacyte type (5.3%, 8/151). According to the mSMART risk stratification system, the proliferation pattern of myeloma cells in the high-risk group was mainly diffuse type, and the morphology was mainly immature and plasmacyte type. In the middle-risk group, mature type myeloma cells were mainly nodular proliferating. In the low-risk and negative group, mature type myeloma cells were mainly interstitial proliferating. There was no difference in the probability of different proliferation modes of intermediate type plasma cells in each group.Conclusions:The proliferation pattern and morphology of plasma cells in bone marrow biopsy combined with cytogenetic markers can more accurately predict the severity and prognosis of MM.