Cirkulující plazmocyty u monoklonálních gamapatií

English version

Autoři: R. Bezdekova ^1,2; M. Penka ¹; R. Hájek ^2,3; L. Rihova ^1,2
Působiště autorů: Department of Clinical Hematology, University Hospital Brno, Czech Republic ¹; Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic ²; Department of Haematooncology, University Hospital Ostrava, Czech Republic ³
Vyšlo v časopise: Klin Onkol 2017; 30(Supplementum2): 29-34
Kategorie: Přehled
doi: https://doi.org/10.14735/amko20172S29

Souhrn

Východiska:
Monoklonální gamapatie jsou charakteristické přítomností klonálních plazmocytů v kostní dřeni, nicméně cirkulující plazmatické buňky lze u významné části pacientů nalézt i v periferní krvi. Počet cirkulujících plazmatických buněk je nezávislým prognostickým faktorem asociovaným s kratším přežíváním, ale také může napomoci předvídat časný relaps. Příčina a mechanizmus vycestování klonálních plazmocytů z kostní dřeně stále není objasněna, nicméně může zahrnovat např. změny v expresi adhezivních molekul. Multiparametrická průtoková cytometrie umožňuje jednoduché a přesné stanovení zastoupení cirkulujících plazmocytů v jakékoli buněčné suspenzi, a to i při velmi nízkých počtech, vč. stanovení jejich fenotypu a potvrzení příslušnosti ke klonálním plazmocytům kostní dřeně. V současnosti však v klinických laboratořích není používán jednotný postup k analýze cirkulujících plazmocytů.

Cíl:
Souhrnná práce popisuje využití průtokové cytometrie v analýze cirkulujících plazmocytů v periferní krvi. Zaměřuje se na možnosti detekce pomocí různých přístupů a také na klinický význam stanovení těchto buněk s cílem standardizace analýz.

Závěr:
Multiparametrická průtoková cytometrie je vhodnou a dostatečně citlivou metodou pro detekci cirkulujících myelomových klonálních plazmocytů. Využití standardizovaného přístupu může vést ke stanovení a zavedení nového „průtokově cytometrického” diagnostického kritéria u suspektních případů plazmocelulární leukemie, a může být využito také v rámci prognostikace pacientů s monoklonální gamapatií. Mimoto, stanovení fenotypového profilu klonálních plazmocytů by mohlo napomoci objasnit jejich budoucí chování.

Klíčová slova:
monoklonální gamapatie – crkulující plazmatické buňky – plazmocelulární leukemie – průtoková cytometrie

Práce byla podpořena grantem MZ ČR – RVO (FNBr, 65269705).

Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy.

Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů.

Obdrženo:
23. 6. 2017

Přijato:
30. 6. 2017

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