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KMID : 0350519940470010505
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Journal of Catholic Medical College
1994 Volume.47 No. 1 p.505 ~ p.513
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Relationship of Flow Cytometric DNA Content to Pathological Parameters in Plasma Cell Myeloma
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Abstract
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Bone marrow aspirates and biopsies from 40 patients with untreated, secreting plasma cell myeloma were investigated to determine the biologic and potential clinical usefulness of various prognostic predictors. Ploidy analysis and measurement of
S-phase
fraction were performed by DNA flow cytometry. On the basis of M-component production of myelomas, they were divided into either 3 group-IgG k(16 cases), IgG λ(11 cases), IgA k(5 cases), or 2 groups-k(21 cases) and λ(11 cases). Seven patients
with
benign monoclonal gammopathy were used as control group in DNA analysis. The secreting pattern of myeloma cells and their relationship to DNA variables(such as ploidy type and S-phase fraction) and myeloma staging system were studied. DNA
variables
variables and their correlations to staging system, hematological parameters, and histological parameters were also investigated.
@ES The results were as follows:
@EN 1. Aneuploidy was detected in 18 cases of plasma cell myeloma (45.0%).
2. There was no significant difference between secretory pattern of myeloma cells and staging system. There was also no significant difference among IgG k, IgG λ, IgA k groups in DNA ploidy. However, the incidence of aneuploidy in the k chain
group(85.7%) significantly higher than that in the λchain group(27.3%).
3. There were no significnat relationships between DNA ploidy and histological grade, and between DNA ploidy and cellularity of myeloma.
4. The incidence of DNA aneuploidy in clinical stage Ⅲsignificantly higher than thadin I and Ⅱ, but there was no significant difference between stage I and Ⅱ.
5. When compared between hematological parameters and ploidy analysis, the platelet count(P=0.006) in the diploidy group was significantly higher than in the aneuploidy group. The serum lactate dehydrogenase level(P=0.016) in the aneuploidy
group
was
significantly higher than that in the diploidy group. There were no good correlations between the remaining hematological parameters and ploidy analysis.
6. There were no significantly correlations betwen hematological parameters and DNA S-phase fraction, and between hematological parameters and clinical staging system.
In conclusion, it suggest that DNA ploidy analysis provided better initial assessment and followup of untreated myeloma patients, because it correlated very well with clinical staging system. Although platelet count and serum lactate
dehydrogenase
level
do not show any significant correlation with staging system, there was good correlation between the former and ploidy types. Therefore, the possibility that the platelet count carries independent predictors of prognosis cannot becompletely
excluded, and
the intimate association between the platelet count and different DNA content groups may indicate true biological differences between the groups.
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