[Clinical role of Morphology in Diagnosing Bone Marrow Involvement of Diffuse Large B Bell Lymphoma].

OBJECTIVE: To determine the significance of morphology of bone marrow smear for diagnosis of bone marrow involvement in patients with diffuse large B-cell lymphoma (DLBCL), and to study the morphological characteristics of DLBCL cells involved in bone marrow. METHODS: Four hundred and twenty cases of DLBCL diagnosed at Peking Union Hospital from 2006 to 2016 were analyzed and identified. RESULTS: Blinded analysis of bone marrow smear and bone marrow biopsy data showed involvement in 42 cases on smears (S), in 47cases by biopsy (B) and the in 49 cases by (S+B). There was an excellent correlation between 2 methods diagnosing the bone marrow infiltration of DLBCL independently (κ=0.889). The morphological features of DLBCL cells involved in bone marrow were of medium sizes, round or irregular nuclear. The chromatin presented dark purple rea and coarse granular, and most of them had 1-5 nucleoli. The amount of cytoplasm was moderate with the color of dark blue or greyish blue. Vacuoles and pseudopodia were common. CONCLUSION: The morphological examination of bone marrow cells has a certain role in the diagnosing bone marrow involvement in patients with DLBCL, and the atypical lymphoid cells making up ≥1% of the total nucleated cells highly suggests the bone marrow involvement in the patients with DLBCL.

Clinical presentation and prognosis of immunoglobulin light-chain amyloidosis with high percentage of bone marrow plasma cells.

OBJECTIVE: To summarize the clinical features and outcomes in Chinese patients with immunoglobulin light-chain (AL) amyloidosis with ≥10% bone marrow plasma cells (BMPCs). METHODS: We retrospectively compared the clinical features and outcomes between patients with ≥10% BMPCs (high-BMPC group; n = 56) and those with <10% BMPCs (low-BMPC group; n = 311). RESULTS: Patients in the high-BMPC group had significantly higher levels of N-terminal pro-brain natriuretic peptide, significantly lower levels of 24 h urine protein, and significantly higher levels of difference between the involved and uninvolved serum free light chains (485.3 versus 121.1 mg/L, P < 0.001). Patients in the high-BMPC group had significantly higher early mortality within 3 months of diagnosis (21.4% versus 10.9%, P = 0.018). In a 3-month landmark analysis, median progression-free survival durations were 17.3 and 34.5 months (P = 0.01), and the median overall survival durations were 24.4 months and not reached in the high- and low-BMPC groups, respectively (P = 0.005). CONCLUSION: Patients with AL amyloidosis and ≥10% BMPCs have higher mortality within 3 months of diagnosis and poorer prognosis compared with patients with <10% BMPCs.

[Morphology Manifestation of Bone Marrow Cells in 155 Newly- Diagnosed Patients with POEMS Syndrome].

OBJECTIVE: To investigate the morphological manifestation of bone marrow cells in newly-diagnosed patients with POEMS syndrome. METHODS: The bone marrow cells in 155 patients with POEMS syndrome were classified and counted by OLYMPUS BX51 microscope, and the abnormal morphology of bone marrow cells was observed. RESULTS: The count of plasma cells with normal morphology was 83.9% (130/155), the count of plasma cells with abnormal morphology (< 5 percent) was 12.3% (19/155), the count of plasma cells with obvious abnormal morphology (> 10 percent) was 3.8% (6/155) in patients with POEMS syndrome. CONCLUSION: The morphology of plasma cells in the most patients with the POEMS syndrome are normal, the minor patients of the POEMS syndrome have little abnormal plasma cell morphology, the extremely few patients showed obvious morphological abnormality in the bone marrow plasma cells. The higher proportion of plasma cells, the more easily and more abnormal plasma cells will be found.