FLOW CYTOMETRY BASED MRD ANALYSIS VERSUS IMMUNOFIXATION ELECTROPHORESIS FOR RESPONSE ASSESSMENT OF MYELOMA PATIENTS ON TREATMENT
(Abstract release date: 05/19/16)
EHA Library. Sachdeva M. 06/09/16; 134896; PB1996
Dr. Man Updesh Singh Sachdeva
Contributions
Contributions
Abstract
Abstract: PB1996
Type: Publication Only
Background
Minimal residual disease (MRD) analysis by multiparametric flow cytometry (MFC) is a sensitive method to evaluate treatment efficacy in patients of plasma cell myeloma (PCM), and also as a tool for predicting patient outcomes and guiding therapeutic decisions. In the present study, we compared MRD levels in patients of plasma cell myeloma after chemotherapy or autologous stem cell transplant (ASCT), assessed by MFC, with immunofixation electrophoresis (IFE) and also the serum M-band status.
Aims
To evaluate the utility of MFC (six colour - three tubes) assay for detection of residual disease in patients of PCM and compare it with results of serum protein electrophoresis (SPEP) for M-band and immunofixation electrophoresis (IFE) done at same time.
Methods
Twenty six PCM patients (16 males & 10 females) were included in the study with mean age of 55.5 (range 37-80) years. Nine patients were post-ASCT (day +100), and 17 patients were on chemotherapy (majority treated with combination of cyclophosphamide, bortezomib and dexamethasone) and had completed induction at time of MRD analysis. MRD was analyzed using a dual laser BD FACS Canto II. Pre-titrated cocktail of CD38, CD138, CD19, CD45, cytoplasmic Kappa and lambda light chain, CD56, CD81, CD27, CD28 and CD200 were used in 6-color combination of three tubes for MRD analysis. IFE and M-band detection were also performed and compared.
Results
Ten out of 26 patients had detectable residual disease by MFC and/or IFE. MRD by MFC was detectable in 8 patients with mean of 1.79% (0.004 – 6.44%), all eight belonging to post-induction chemotherapy group. Only 4 of these 8 patients (50%) revealed both IFE positivity and detectable M-band. Two out of these 10 patients were MRD negative, however revealed IFE positivity as well as detectable M-band in one, and the other patient was only IFE positive (Table 1). Remaining 16 patients did not show evidence of residual disease by any of the three methods. Statistical analysis between MRD-positive (8/26) and MRD-negative (18/26) groups revealed no significant difference between age and sex distribution, mean values of hemoglobin, leukocyte count, platelet count, serum creatinine, serum calcium and serum albumin and the mean percentage of plasma cells on bone marrow aspirate smears (Mann-Whitney U test).Table 1: Comparison of results of the 10 patients showing persistent residual disease by SPEP/ IFE/ MFC, along with plasma cell percentages on bone marrow aspirate smears.
Conclusion
MRD detection by multiparametric flow cytometry is a sensitive technique and should be routinely performed in addition to immunofixation electrophoresis and serum protein electrophoresis for more accurate assessment of treatment-response, better prognostication and further management of plasma cell myeIoma patients.
Session topic: E-poster
Keyword(s): Minimal residual disease (MRD), Multiple myeloma, Plasma cells
Type: Publication Only
Background
Minimal residual disease (MRD) analysis by multiparametric flow cytometry (MFC) is a sensitive method to evaluate treatment efficacy in patients of plasma cell myeloma (PCM), and also as a tool for predicting patient outcomes and guiding therapeutic decisions. In the present study, we compared MRD levels in patients of plasma cell myeloma after chemotherapy or autologous stem cell transplant (ASCT), assessed by MFC, with immunofixation electrophoresis (IFE) and also the serum M-band status.
Aims
To evaluate the utility of MFC (six colour - three tubes) assay for detection of residual disease in patients of PCM and compare it with results of serum protein electrophoresis (SPEP) for M-band and immunofixation electrophoresis (IFE) done at same time.
Methods
Twenty six PCM patients (16 males & 10 females) were included in the study with mean age of 55.5 (range 37-80) years. Nine patients were post-ASCT (day +100), and 17 patients were on chemotherapy (majority treated with combination of cyclophosphamide, bortezomib and dexamethasone) and had completed induction at time of MRD analysis. MRD was analyzed using a dual laser BD FACS Canto II. Pre-titrated cocktail of CD38, CD138, CD19, CD45, cytoplasmic Kappa and lambda light chain, CD56, CD81, CD27, CD28 and CD200 were used in 6-color combination of three tubes for MRD analysis. IFE and M-band detection were also performed and compared.
Results
Ten out of 26 patients had detectable residual disease by MFC and/or IFE. MRD by MFC was detectable in 8 patients with mean of 1.79% (0.004 – 6.44%), all eight belonging to post-induction chemotherapy group. Only 4 of these 8 patients (50%) revealed both IFE positivity and detectable M-band. Two out of these 10 patients were MRD negative, however revealed IFE positivity as well as detectable M-band in one, and the other patient was only IFE positive (Table 1). Remaining 16 patients did not show evidence of residual disease by any of the three methods. Statistical analysis between MRD-positive (8/26) and MRD-negative (18/26) groups revealed no significant difference between age and sex distribution, mean values of hemoglobin, leukocyte count, platelet count, serum creatinine, serum calcium and serum albumin and the mean percentage of plasma cells on bone marrow aspirate smears (Mann-Whitney U test).Table 1: Comparison of results of the 10 patients showing persistent residual disease by SPEP/ IFE/ MFC, along with plasma cell percentages on bone marrow aspirate smears.
| S. No. | SPEP | IFE | MRD (%) | Plasma cells on morphology (%) |
| 1. | Negative | Negative | 0.07 | 2 |
| 2. | Negative | Negative | 0.11 | 1 |
| 3. | Negative | Negative | 0.41 | 1 |
| 4. | Negative | Negative | 0.7 | 4 |
| 5. | Positive | Positive | 0.004 | 1 |
| 6. | Positive | Positive | 3.2 | 15 |
| 7. | Positive | Positive | 3.4 | 0 |
| 8. | Positive | Positive | 6.44 | 22 |
| 9. | Positive | Positive | 0 | 2 |
| 10. | Negative | Positive | 0 | 1 |
Conclusion
MRD detection by multiparametric flow cytometry is a sensitive technique and should be routinely performed in addition to immunofixation electrophoresis and serum protein electrophoresis for more accurate assessment of treatment-response, better prognostication and further management of plasma cell myeIoma patients.
Session topic: E-poster
Keyword(s): Minimal residual disease (MRD), Multiple myeloma, Plasma cells
Abstract: PB1996
Type: Publication Only
Background
Minimal residual disease (MRD) analysis by multiparametric flow cytometry (MFC) is a sensitive method to evaluate treatment efficacy in patients of plasma cell myeloma (PCM), and also as a tool for predicting patient outcomes and guiding therapeutic decisions. In the present study, we compared MRD levels in patients of plasma cell myeloma after chemotherapy or autologous stem cell transplant (ASCT), assessed by MFC, with immunofixation electrophoresis (IFE) and also the serum M-band status.
Aims
To evaluate the utility of MFC (six colour - three tubes) assay for detection of residual disease in patients of PCM and compare it with results of serum protein electrophoresis (SPEP) for M-band and immunofixation electrophoresis (IFE) done at same time.
Methods
Twenty six PCM patients (16 males & 10 females) were included in the study with mean age of 55.5 (range 37-80) years. Nine patients were post-ASCT (day +100), and 17 patients were on chemotherapy (majority treated with combination of cyclophosphamide, bortezomib and dexamethasone) and had completed induction at time of MRD analysis. MRD was analyzed using a dual laser BD FACS Canto II. Pre-titrated cocktail of CD38, CD138, CD19, CD45, cytoplasmic Kappa and lambda light chain, CD56, CD81, CD27, CD28 and CD200 were used in 6-color combination of three tubes for MRD analysis. IFE and M-band detection were also performed and compared.
Results
Ten out of 26 patients had detectable residual disease by MFC and/or IFE. MRD by MFC was detectable in 8 patients with mean of 1.79% (0.004 – 6.44%), all eight belonging to post-induction chemotherapy group. Only 4 of these 8 patients (50%) revealed both IFE positivity and detectable M-band. Two out of these 10 patients were MRD negative, however revealed IFE positivity as well as detectable M-band in one, and the other patient was only IFE positive (Table 1). Remaining 16 patients did not show evidence of residual disease by any of the three methods. Statistical analysis between MRD-positive (8/26) and MRD-negative (18/26) groups revealed no significant difference between age and sex distribution, mean values of hemoglobin, leukocyte count, platelet count, serum creatinine, serum calcium and serum albumin and the mean percentage of plasma cells on bone marrow aspirate smears (Mann-Whitney U test).Table 1: Comparison of results of the 10 patients showing persistent residual disease by SPEP/ IFE/ MFC, along with plasma cell percentages on bone marrow aspirate smears.
Conclusion
MRD detection by multiparametric flow cytometry is a sensitive technique and should be routinely performed in addition to immunofixation electrophoresis and serum protein electrophoresis for more accurate assessment of treatment-response, better prognostication and further management of plasma cell myeIoma patients.
Session topic: E-poster
Keyword(s): Minimal residual disease (MRD), Multiple myeloma, Plasma cells
Type: Publication Only
Background
Minimal residual disease (MRD) analysis by multiparametric flow cytometry (MFC) is a sensitive method to evaluate treatment efficacy in patients of plasma cell myeloma (PCM), and also as a tool for predicting patient outcomes and guiding therapeutic decisions. In the present study, we compared MRD levels in patients of plasma cell myeloma after chemotherapy or autologous stem cell transplant (ASCT), assessed by MFC, with immunofixation electrophoresis (IFE) and also the serum M-band status.
Aims
To evaluate the utility of MFC (six colour - three tubes) assay for detection of residual disease in patients of PCM and compare it with results of serum protein electrophoresis (SPEP) for M-band and immunofixation electrophoresis (IFE) done at same time.
Methods
Twenty six PCM patients (16 males & 10 females) were included in the study with mean age of 55.5 (range 37-80) years. Nine patients were post-ASCT (day +100), and 17 patients were on chemotherapy (majority treated with combination of cyclophosphamide, bortezomib and dexamethasone) and had completed induction at time of MRD analysis. MRD was analyzed using a dual laser BD FACS Canto II. Pre-titrated cocktail of CD38, CD138, CD19, CD45, cytoplasmic Kappa and lambda light chain, CD56, CD81, CD27, CD28 and CD200 were used in 6-color combination of three tubes for MRD analysis. IFE and M-band detection were also performed and compared.
Results
Ten out of 26 patients had detectable residual disease by MFC and/or IFE. MRD by MFC was detectable in 8 patients with mean of 1.79% (0.004 – 6.44%), all eight belonging to post-induction chemotherapy group. Only 4 of these 8 patients (50%) revealed both IFE positivity and detectable M-band. Two out of these 10 patients were MRD negative, however revealed IFE positivity as well as detectable M-band in one, and the other patient was only IFE positive (Table 1). Remaining 16 patients did not show evidence of residual disease by any of the three methods. Statistical analysis between MRD-positive (8/26) and MRD-negative (18/26) groups revealed no significant difference between age and sex distribution, mean values of hemoglobin, leukocyte count, platelet count, serum creatinine, serum calcium and serum albumin and the mean percentage of plasma cells on bone marrow aspirate smears (Mann-Whitney U test).Table 1: Comparison of results of the 10 patients showing persistent residual disease by SPEP/ IFE/ MFC, along with plasma cell percentages on bone marrow aspirate smears.
| S. No. | SPEP | IFE | MRD (%) | Plasma cells on morphology (%) |
| 1. | Negative | Negative | 0.07 | 2 |
| 2. | Negative | Negative | 0.11 | 1 |
| 3. | Negative | Negative | 0.41 | 1 |
| 4. | Negative | Negative | 0.7 | 4 |
| 5. | Positive | Positive | 0.004 | 1 |
| 6. | Positive | Positive | 3.2 | 15 |
| 7. | Positive | Positive | 3.4 | 0 |
| 8. | Positive | Positive | 6.44 | 22 |
| 9. | Positive | Positive | 0 | 2 |
| 10. | Negative | Positive | 0 | 1 |
Conclusion
MRD detection by multiparametric flow cytometry is a sensitive technique and should be routinely performed in addition to immunofixation electrophoresis and serum protein electrophoresis for more accurate assessment of treatment-response, better prognostication and further management of plasma cell myeIoma patients.
Session topic: E-poster
Keyword(s): Minimal residual disease (MRD), Multiple myeloma, Plasma cells
{{ help_message }}
{{filter}}