Abstract
Multiparametric Flow Cytometry (MFC) for Immunophenotyping is a very useful tool for diagnosis of Waldenstrom’s macroglobulinemia (WM). It can be used for the distinction between different entities that can be responsible for an IgM monoclonal component, including IgM monoclonal gammopathy undetermined significance (MGUS), asymptomatic WM, and symptomatic WM, as well as other close B-cell lymphoproliferative disorders, such as chronic lymphocytic leukemia, marginal zone lymphoma and IgM multiple myeloma. The identification and quantification of a clonal cell population with a typical WM phenotype is almost diagnostic of this disorder. Clonal WM lymphocytes are characterized by the constant expression of pan-B markers (CD19, CD20, CD22, CD24) and surface immunoglobulin, and are usually positive for FMC7, CD25, CD27, CD45RA, and BCL-2. Moreover, these lymphocytes are almost always negative for CD103, CD11c, CD10 antigens, and frequently negative for CD5 and CD23. Plasma cells present in WM are characterized by an immunophenotype indistinguishable from normal plasma cells, although they belong to the tumor clone. Immunophenotyping also helps to evaluate the response of the disease to the therapy, and it is probably a better monitoring parameter that the M-component, the usual way to evaluate the disorder outcome. In this work, all these concepts are reviewed in detail to help in the comprehension of the use of MFC in WM.
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Acknowledgments
The authors thank Alicia Antón, Montserrat Ruano, and Rebeca Maldonado for their technical assistance. This work has been partially supported by the grant PI12/02311 from the Spanish “Instituto de Salud Carlos III (ISCIII)” and GRS 847/A/13 from the Consejería de Sanidad de la Junta de Castilla y León and the Cooperative Research Thematic Network (RTICC) RD12/0036/0046-0048-0058 and Solórzano FS/23-2014.
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Puig, N., Ocio, E.M., Jiménez, C., Paiva, B., Miguel, J.F.S., García-Sanz, R. (2017). Waldenström’s Macroglobulinemia Immunophenotype. In: Leblond, V., Treon, S., Dimoploulos, M. (eds) Waldenström’s Macroglobulinemia. Springer, Cham. https://doi.org/10.1007/978-3-319-22584-5_2
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