19例初发多发性骨髓瘤MICM分型分析

Analysis of MICM classification in 19 patients with primary multiple myeloma

目的探讨多发性骨髓瘤(MM)患者MICM分型的特征及应用价值。方法对19例初发多发性骨髓瘤患者的MICM进行回顾性分析。结果骨髓形态学显示,幼稚+成熟浆细胞比例为2.5%~75.5%;多参数流式分析异常浆细胞比例为1.4%~32.8%。抗原阳性表达比例分别为CD138 100%,CD38 100%,CD56 63.1%,CD117 42.1%,CD130%,CD33 26.3%,CD20 5.2%,CD22 0%,CD10 0%,CD19 0%。免疫球蛋白胞浆限制性表达,其中Cκ9例,Cλ10例。免疫固定电泳显示Ig G+κ型4例,Ig A+κ型2例,Ig G+λ型4例,Ig A+λ型1例,。Ig基因重排分析IGH FR1-JH重排阳性者8例,IGH FR2-JH重排阳性者11例,IGH DH-JH重排阳性者2例,IGK Vk-Jk重排阳性者11例,IGK Vk-Kde+intron-Kde重排阳性者8例。结论 MICM分型,对患者治疗方案选择及预后的判断均具有临床价值。

Objective To investigate the characteristics and application of MICM classification.Methods We retrospectively analyzed the MICM of 19 patients with primary multiple myeloma.Results Bone marrow morphological results showed that ratio of naive ＋ mature plasma cells was within 2.5%-75.5%; multi-parameter flow analysis showed that proportion of abnormal plasma cells in MM patients was within 1.4%-32.8%,and positive rate of antigen expression was CD138：100%,CD38：100%,CD56：63.1%,CD117：42.1%,CD13：0%,CD33：26.3%,CD20：5.2%,CD22：0%,CD10：0%,CD19：0%;immunoglobulin cytoplasmic restricted expressed Cκ in 9 cases and Cλ in 10 cases.Immunofixation showed Ig G ＋ kappa type were in 4 cases,Ig A ＋ κ type were in 2 cases,Ig A ＋ λ type was in 4 case,Ig A ＋ λ type were in 1 case; Ig rearrangement analyzed that IGH FR1-JH rearrangement were 8 cases,IGH FR2-JH rearrangement were 11 cases,IGH DH-JH rearrangement were 2 cases,IGK Vk-Jk rearrangement were 11 cases,IGK Vk-Kde ＋ intron-Kde rearrangement were 8 cases.Conclusion MICM classification has clinical value for treatment options and prognosis of judgments in patients.