ABSTRACT
Objective To improve the detection rate of cytogenetic abnormalities of monoclonal plasma cells through quality control cycle (QCC) activities. Methods A QCC team was established to collect the bone marrow samples of patients suspected with multiple myeloma, who undergoing plasma cell-associated fluorescence in situ hybridization (FISH) in Department of Hematology, Changhai Hospital of Navy Medical University (Second Military Medical University) from Jun. 2014 to Dec. 2014. The detection rate of cytogenetic abnormalities of monoclonal plasma cells was analyzed and compared with literatures to find out the difference and related causes, and then the improvement measures were formulated and practiced to evaluate the improvement effect. Results We found that low tumor load in the initial specimen and the detection result could not be judged due to that value is very close to the critical value were the two key points to be improved in the QCC activity. Based on the brainstorming and the existing laboratory conditions, the QCC team chose to sort abnormal cells by flow cytometry to increase tumor cell density and reduce background value before genetic testing. Finally, the detection rate of cytogenetic abnormalities of monoclonal plasma cells increased from 61.3% (95/155) to 92.1% (174/189) in our hospital. Conclusion The FISH detection process of bone marrow of patients suspected with multiple myeloma is optimized through QCC activities, and the detection rate of cytogenetic abnormalities of monoclonal plasma cells is effectively improved.
ABSTRACT
Objective To improve the recognition in clinical features,diagnosis and treatment of POEMS syndrome.Method Twenty-one cases of POEMS syndrome were analyzed retrospectively.Results The major clinical features were shown as follows: 21 cases of polyneuropathy, organomegaly, edema and skin changes, 13 cases of monoclonal plasma proliferative disorder, 19 cases of endocrinopathy, 1 case of sclerotic bone lesions, 1 case of Castleman disease,5 cases of papilledema.Conclusions POEMS syndrome is a rare multi-system damage disease.Screening for POEMS syndrome with serum protein electrophoresis, immunofixation electrophoresis,electromyogram and radionuclide bone scanning are essential for all patients with unexplained peripheral neuropathy or multi-system damage.If the index of suspicion is high enough, bone marrow cytomorphologic examination or biopsy with immunohistochemical staining may be required,in order to make an early diagnosis and try to avoid misdiagnosis and mistherapy.