Detection of clonal plasma cells in POEMS syndrome using multiparameter flow cytometry

Arata Ishii; Shokichi Tsukamoto; Naoya Mimura; Yurie Miyamoto-Nagai; Yusuke Isshiki; Shinichiro Matsui; Sanshiro Nakao; Asuka Shibamiya; Yutaro Hino; Kensuke Kayamori; Nagisa Oshima-Hasegawa; Tomoya Muto; Yusuke Takeda; Tomoki Suichi; Sonoko Misawa; Chikako Ohwada; Koutaro Yokote; Satoshi Kuwabara; Chiaki Nakaseko; Hiroyuki Takamatsu; Emiko Sakaida

doi:10.1038/s41598-024-61034-1

Detection of clonal plasma cells in POEMS syndrome using multiparameter flow cytometry

Sci Rep. 2024 May 6;14(1):10362. doi: 10.1038/s41598-024-61034-1.

Authors

Arata Ishii^{1

2}, Shokichi Tsukamoto^{3

4}, Naoya Mimura^{1

5}, Yurie Miyamoto-Nagai¹, Yusuke Isshiki¹, Shinichiro Matsui¹, Sanshiro Nakao¹, Asuka Shibamiya¹, Yutaro Hino¹, Kensuke Kayamori¹, Nagisa Oshima-Hasegawa¹, Tomoya Muto¹, Yusuke Takeda¹, Tomoki Suichi⁶, Sonoko Misawa⁶, Chikako Ohwada^{1

7}, Koutaro Yokote², Satoshi Kuwabara⁶, Chiaki Nakaseko⁷, Hiroyuki Takamatsu⁸, Emiko Sakaida^{1

2

5}

Affiliations

¹ Department of Hematology, Chiba University Hospital, Chiba, Japan.
² Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan.
³ Department of Hematology, Chiba University Hospital, Chiba, Japan. shokichi.tsukamoto@chiba-u.jp.
⁴ Department of Endocrinology, Hematology, and Gerontology, Chiba University Graduate School of Medicine, Chiba, Japan. shokichi.tsukamoto@chiba-u.jp.
⁵ Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan.
⁶ Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan.
⁷ Department of Hematology, International University of Health and Welfare, Narita, Japan.
⁸ Department of Hematology, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa University, Kanazawa, Japan.

Abstract

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein [M-protein], and skin changes) is a rare systemic disorder characterized by various symptoms caused by underlying plasma cell (PC) dyscrasia. Detection of monoclonal PCs is mandatory for the diagnosis of POEMS syndrome; however, the usefulness of EuroFlow-based next-generation flow cytometry (EuroFlow-NGF) in POEMS syndrome for detecting monoclonal PCs in bone marrow (BM) and the gating strategy suitable for flow cytometry study of POEMS syndrome remain unknown. We employed EuroFlow-NGF-based single-tube eight-color multiparameter flow cytometry (MM-flow) and established a new gating strategy (POEMS-flow) to detect the monoclonal PCs in POEMS syndrome, gating CD38 broadly from dim to bright and CD45 narrowly from negative to dim compared to MM-flow. MM-flow detected monoclonal PCs in 9/25 (36.0%) cases, including 2/2 immunofixation electrophoresis (IFE)-negative cases (100%). However, POEMS-flow detected monoclonal PCs in 18/25 cases (72.0%), including 2/2 IFE-negative cases (100%). POEMS-flow detected monoclonal PCs with immunophenotypes of CD19^- in 17/18 (94.4%). In six cases where post-treatment samples were available, the size of the clones was significantly reduced after the treatment (P = 0.031). POEMS-flow can enhance the identification rate of monoclonal PCs in POEMS syndrome and become a valuable tool for the diagnosis of POEMS syndrome.

Keywords: EuroFlow; Immunophenotype; Multiparameter flow cytometry; POEMS syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Bone Marrow / pathology
Female
Flow Cytometry* / methods
Humans
Immunophenotyping / methods
Male
Middle Aged
POEMS Syndrome* / diagnosis
Plasma Cells* / metabolism
Plasma Cells* / pathology