Immunophenotypic Profile of Multiple Myeloma: A Tertiary Care Centre Experience

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Background Immunophenotyping and enumeration of plasma cells (PCs) by flow cytometry are deemed to be prognostically significant. However, PCs enumeration by flow cytometry is challenging owing to discrepancy with morphology and PCs loss during sample processing. Enumeration and differentiation of abnormal plasma cells (APCs) and normal plasma cells (NPCs) is difficult because abnormal antigen expression can be seen in subsets of NPCs. This is particularly true when a limited panel of antibodies are relied upon.

Aims and purpose To study the immunophenotypic profile of newly diagnosed multiple myeloma (MM) cases by flow cytometry and evaluate the sensitivities and specificities of individual antigens and combinations.

Methods We studied immunophenotype of PCs in newly diagnosed MM cases (n = 48) and control cases (n = 10) by a 6-color, 3-tube flow cytometry panel. The sensitivities and specificities of antigens in MM were evaluated and compared with control cases.

Results Majority of MM cases (n = 43) had < 3% NPCs. CD19 was the most sensitive (100%) and CD81 was the most specific marker (100%) for differentiating APCs from NPCs. CD38 MFI came out as a useful marker for APCs identification. In combination, CD19 and CD81 had a higher sensitivity and specificity to detect APCs.

Conclusion NPCs may show aberrant antigen expression. A combination of multiple markers including CD81 and CD38 MFI should be used for accurate APC detection.

Keywords multiple myeloma - immunophenotype - flow cytometry - CD38MFI Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Ethical Approval

The study is approved by institute ethics committee with reference number IECPG-293/29.05.2019.


Informed Consent

Informed consent was obtained from all individual participants included in the study.


Publication Consent

Consent for publication was obtained for every individual person's data included in the study.


Data Availability

The datasets generated and analyzed during this study are available from the corresponding author on reasonable request.


Authors' and Co-authors' Contributions

AR processed the samples, analyzed the flow cytometry data, and wrote the manuscript. ST conceptualized and designed the study, analyzed the data, and wrote the manuscript. JD reviewed the morphology and analyzed the data. TS and MM reviewed the data and provided the clinical information.

Publication History

Article published online:
30 January 2023

© 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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