Philip R. Greipp

Immunofluorescence labeling indices in myeloma and related monoclonal gammopathies.

We measured plasma cell labeling indices (LI) in 52 patients with monoclonal gammopathies. Cytoplasmic reactivity with polyspecific or kappa- and lambda-specific light chain anti-Ig reagents identified monoclonal plasma cells, plasmablasts, and lymphocytoid plasma cells. Among newly diagnosed untreated patients, a high immunofluorescence LI distinguished those with multiple myeloma (MM) from those with stable monoclonal gammopathies (P less than 0.002). Among treated patients with MM, those in the plateau phase of the disease had low LI, whereas patients in the relapse phase or early in treatment had high LI. The immunofluorescence LI correctly classified three more patients with newly diagnosed MM than did the tritiated thymidine LI technique. LI specific for the neoplastic plasma cells resulted in excellent discrimination of patients with active disease. Because results are easily and rapidly obtained, this technique is useful clinically.

Hematologic Malignancies: Multiple Myeloma and Related Plasma Cell Disorders

1 Monoclonal Gammopathies of Undetermined Significance and Smoldering Multiple Myeloma.- 2 Neuropathy Associated With Plasma Cell Proliferative Disorders.- 3 Multiple Myeloma.- 4 Solitary Plasmacytoma of Bone and Extramedullary Plasmacytoma.- 5 Plasma Cell Leukemia.- 6 Heavy Chain Diseases.- 7 Immunoglobulin Light Chain Amyloidosis (Primary Amyloidosis, AL).- 8 Light Chain Deposition Disease.- 9 Waldenstroem Macroglobulinemia.- 10 Cryoglobulinemia.- 11 Acquired Fanconi Syndrome Associated With Monoclonal Plasma Cell Disorders.