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Abstract
POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein [M-protein], and skin changes) is a rare systemic disorder characterized by various symptoms caused by underlying plasma cell (PC) dyscrasia. Detection of monoclonal PCs is mandatory for the diagnosis of POEMS syndrome; however, the usefulness of EuroFlow-based next-generation flow cytometry (EuroFlow-NGF) in POEMS syndrome for detecting monoclonal PCs in bone marrow (BM) and the gating strategy suitable for flow cytometry study of POEMS syndrome remain unknown. We employed EuroFlow-NGF-based single-tube eight-color multiparameter flow cytometry (MM-flow) and established a new gating strategy (POEMS-flow) to detect the monoclonal PCs in POEMS syndrome, gating CD38 broadly from dim to bright and CD45 narrowly from negative to dim compared to MM-flow. MM-flow detected monoclonal PCs in 9/25 (36.0%) cases, including 2/2 immunofixation electrophoresis (IFE)-negative cases (100%). However, POEMS-flow detected monoclonal PCs in 18/25 cases (72.0%), including 2/2 IFE-negative cases (100%). POEMS-flow detected monoclonal PCs with immunophenotypes of CD19− in 17/18 (94.4%). In six cases where post-treatment samples were available, the size of the clones was significantly reduced after the treatment (P = 0.031). POEMS-flow can enhance the identification rate of monoclonal PCs in POEMS syndrome and become a valuable tool for the diagnosis of POEMS syndrome.
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1 Chiba University Hospital, Department of Hematology, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959); Chiba University Graduate School of Medicine, Department of Endocrinology, Hematology, and Gerontology, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)
2 Chiba University Hospital, Department of Hematology, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959); Chiba University Hospital, Department of Transfusion Medicine and Cell Therapy, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959)
3 Chiba University Hospital, Department of Hematology, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959)
4 Chiba University Graduate School of Medicine, Department of Neurology, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)
5 Chiba University Hospital, Department of Hematology, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959); International University of Health and Welfare, Department of Hematology, Narita, Japan (GRID:grid.411731.1) (ISNI:0000 0004 0531 3030)
6 Chiba University Graduate School of Medicine, Department of Endocrinology, Hematology, and Gerontology, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101)
7 International University of Health and Welfare, Department of Hematology, Narita, Japan (GRID:grid.411731.1) (ISNI:0000 0004 0531 3030)
8 Kanazawa University, Department of Hematology, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
9 Chiba University Hospital, Department of Hematology, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959); Chiba University Graduate School of Medicine, Department of Endocrinology, Hematology, and Gerontology, Chiba, Japan (GRID:grid.136304.3) (ISNI:0000 0004 0370 1101); Chiba University Hospital, Department of Transfusion Medicine and Cell Therapy, Chiba, Japan (GRID:grid.411321.4) (ISNI:0000 0004 0632 2959)