Immunophenotype, Molecular Cytogenetic Abnormalities And Their Relation To Clinical Prognostic Indicators In Multiple Myeloma

Objective: This study was purposed to investigate the immunophenotype andmolecular cytogenetic characteristics in multiple myeloma (MM), clear characteristicimmunophenotype of malignant plasma cell and stability, investigate the inner relationshipbetween different antigen expression patterns and molecular genetics abnormalities, aswell as the potential relationship to their clinical prognostic indicators, provide basis forthe multiple myeloma ’s Diagnosis, evaluation, prognosis, Minimal residual disease andmonoclonal treatment.Methods: Detect the expression levels of various immunologic markers of50cases ofMM patients and20cases of Iron deficiency anemia patients with normal chromosomeover the same time by flow cytometry (FCM); analysis tumor cell surface abnormalantigen expression patterns and antigen expression of stability; at the same time collec theclinical and laboratory parameters of the patients to analyze the difference between theexpression of CD56、 CD19、CD117、CD28,、CD20、CD27and the clinical stage, diseasestage, type of immunoglobulin,find out their correlations with clinical indicator; Detecting13q deletion, IGH rearrangement, P53deletion and lq21amplification of36cases of bonemarrow cells in MM patients by interphase fluorescence in situ hybridization(I-FISH),investigate the inner relationship between antigen expression patterns andmolecular genetics abnormalities, as well as the potential relationship between theirclinical prognostic indicators.Results:(1) Contrast to control, the frequency of surface antigen abnormal expressionin50cases of MM patients is: CD19-(96%), CD56+(90%), CD117+(54%), CD27-(67%), CD28+(76%), CD20+(44%), and almost (92%) express CD19-CD56+. and some of immunophenotypes has changes after non-monoclonal antibody therapy(42.85%).(2)The expression of CD28in MM has statistically significant differences betweenstageⅠand stage Ⅱ+Ⅲ according to DS stage (F=6.626, P=0.004)and the frequency ofexpression increased with advanced stages. At the same time the results show thatExpression of CD28was associated with a significant higher frequency of advancedInternational staging system (ISS) stages, higher levels of BM infiltration (PC≥30%)andβ2-microglobulin（β2-MG≥2mg/dL）,greater frequencies of anemia（Hemoglobin≦100g/l),Hypercalcemia（calcium≥2.75mmol/l）, renal impairment (creatinine≥2mg/dL), lowalbumin(albumin≦30g/l), and IGH translocations. In turn, lack of CD117expression wasassociated with higher levels of BM infiltration, greater frequencies of low albumin. Theothers antigen expression in clinical stage, disease stage, immunoglobulin type were nostatistically significant differences models.(3) Contrast to normal controls,13q14.3deletion accounted for55.56%(including thedeletion of13q14.3and RB1). And the proportion in stage Ⅲ patients is higher than I, IIpatients.61.11%of the patients present IGH translocation, Further analysis revealed thereis correlation existed between del (13q14) and IGH translocation(r=0.378,p=0.023), andmore common of CD117-patients (P=0.024), but no correlation with the clinicalindicators.(4) In MM patients, the combined expression of CD117-CD28-or CD28+CD117+accounted for52%(26/50),CD117-,CD28-accounted for26%(13/50), CD28+CD117-accounted for22%(11/50). There were9cases of patients with del (13q14) in11cases ofpatients with CD28+CD117-, and was statistically significant between them (P <0.05).But we didn’t found the statistical signification between the other antigen expressionpatterns and genetic abnormalities.Conclusion: The immunologic markers expression patterns of myeloma tumor celldetected by flow cytometry provide basis for the diagnosis, evaluation, prognosis, minimal residual disease and monoclonal treatment. Given the heterogeneity and instability of antigenexpression in tumor cells more antigen detection is required in detecting minimalresidual disease by flow cytometry and treating by monoclonal antibody. On the other hand,the potential correlation between molecular genetic abnormalities and expression patternsof specific antigens can help identify prognostic risk stratification and guide clinicaltreatment, still further large-scale study is required.