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proliferative disorder patients Determining plasma cell DNA content and proliferation<br />

Interpretation: Plasma Cell Clonality: Plasma cell populations with a kappa to lambda ratio of either<br />

>3.9 or or =3.0 is<br />

associated with a more aggressive disease course.(1,2) As there was a 100% concordance between a PCLI<br />

of >3.0 and an estimated S-phase of >1.5%, and this value is published standard for identifying plasma<br />

cell neoplasms with a high proliferative rate, it will be noted in the report if the estimated S-phase exceeds<br />

this value.(3,4)<br />

Reference Values:<br />

Plasma Cell Clonality:<br />

Normal bone marrow<br />

No clonal plasma cells detected<br />

DNA Index:<br />

Normal plasma cells<br />

DNA index (G0/G1 cells): Diploid 0.95-1.05<br />

Clinical References: 1. Kumar SK, Mikhael JR, Buadi FK, et al: Management of newly diagnosed<br />

symptomatic multiple myeloma: updated <strong>Mayo</strong> Stratification of Myeloma and Risk-Adapted Therapy<br />

(mSMART) consensus guidelines. <strong>Mayo</strong> Clin Proc 2009 Dec;84(12):1095-1110 2. Rajkumar SV, Greipp<br />

PR: Prognostic factors in multiple myeloma. Hematol Oncol Clin North Am 1999 Dec;13(6):1295-1314<br />

3. Garcia-Sanz R, Gonzalez-Fraile MI, Mateo G, et al: Proliferative activity of plasma cells is the most<br />

relevant prognostic factor in elderly multiple myeloma patients. Int J Cancer 2004 Dec 10;112(5):884-889<br />

4. Orfao A, Garcia-Sanz R, Lopez-Berges MC, et al: A new method for the analysis of plasma cell DNA<br />

content in multiple myeloma samples using a CD38/propidium iodide double staining technique.<br />

Cytometry 1994 Dec 1;17(4):332-339 5. Morice WG, Hanson CA, Kumar S, et al: Novel multi-parameter<br />

flow cytometry sensitively detects phenotypically distinct plasma cell subsets in plasma cell proliferative<br />

disorders. Leukemia 2007 Sep;21(9):2043-2046 6. Morice WG, Chen D, Kurtin PJ, et al: Novel<br />

immunophenotypic features of marrow lymphoplasmacytic lymphoma and correlation with<br />

Waldenstrom's macroglobulinemia. Mod Pathol 2009 Jun;22(6):807-816<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1427

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