Plasma Cell Enrichment: Increasing the Detection Rate of Plasma Cell Disorders

Plasma cell enrichment techniques concentrate the overall population of plasma cells, thereby increasing the detection and frequency of abnormalities. Cytogenetic analysis of plasma cell disorders (PCD) is difficult due to the low proliferative rate of plasma cells in vitro. Although interphase fluorescence in situ hybridization (FISH) has improved the detection of abnormalities in PCD, cases having a low level of plasma cells often give false negative results by FISH.

In concert with the recommendations by the International Myeloma Working Group, Miraca Life Sciences performs FISH analysis on enriched cells to identify patients with suspected PCD.

Plasma Cell Enrichment

● On average, the percentage of plasma cells from enriched specimens can be ten times greater than nonenriched specimens, thereby increasing the percent of abnormal cells proportionately.

● FISH results from enriched cells can identify genomic aberrations in cases that did not demonstrate a PCD by flow cytometry, morphology, cytogenetics or FISH performed on non-enriched cells.

● Enriched FISH studies can detect abnormalities with as few as 0.04% plasma cells.

● For cases suggesting PCD, Miraca Life Sciences will perform FISH on enriched plasma cells concurrently with flow cytometry and morphology.

● The International MyelomaWorking Group recommends that techniques for plasma cell selection or enrichment should be performed as a routine pre-analytic processin the FISH analysis of all patients with multiple myeloma. 1

1. Fonseca R. et al. International Myeloma Working Group molecular classification of multiple myeloma: spotlight review. Leukemia. 2009;23:2210