الفهرس 
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Abstract
Multiple myeloma is a malignancy of plasma cells which accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. The disease can cause failure of the bone marrow leading to anemia, immune paresis with resultant infection, bone pain and fractures, high calcium levels and renal failure.
Considerable variability has been observed in the prognosis of patients of MM, leading to diverse survival times ranging from several days up to 10 years. MM remains incurable, however remarkable progress has been made leading to advances in treatment that prolong survival.
Standard prognostic classifications used in newly diagnosed MM, such as the Durie-Salmon classification and international staging system, have been put in place for the purpose of risk stratification and have served to evaluate the overall clinical outcome of patients. However, they do not account for the genomic complexity of the disease that leads to a heterogeneous clinical course. Thus, it is imperative to devise new biomarkers that stratify the disease at an individual level and allow tailored therapy to achieve the optimal outcome.
In recent years, multiparameter flow cytometry has considerably increased its diagnostic relevance in MGUS and MM. MFC-based clonality assessment is the most stringent method of diagnosis and follow-up, and provides very useful information to assess the risk of progression from MGUS to MM.
CD45 is strongly expressed in normal immature proliferative plasma cells, but weakly expressed in mature resting plasma cells in bone marrow.
In this study, we aimed to analyze the relationship between CD45 and CD56 expressions on clonal plasma cells; and the clinical characteristics, laboratory parameters and prognosis of multiple myeloma patients using 6-color multiparameter flowcytometry at initial diagnosis.
The patients included in this study were 30 patients with newly diagnosed multiple myeloma. Patients were selected from cases referred to Medical Oncology department, Faculty of Medicine, Cairo University during the period from December 2017 to October 2019. Patients were categorized into 2 subgroups according to the expression of CD45 and CD56. group I included patients with CD45- CD56+, while group II included CD45+CD56+, CD45-CD56-, and CD45+CD56- patients.
For diagnosis of newly diagnosed multiple myeloma patients, complete blood count, peripheral blood smear, bone marrow aspiration, biochemical tests (serum creatinine, calcium, albumin, and B2 microglobulin), serum protein electrophoresis, serum immunofixation studies, free light chain ratio and immunophenotyping by MFC using CD38, CD138, CD45, CD19, CD56, kappa and lambda were done.
No statistically significant differences were detected between the two patients’ groups regarding age, gender, flowcytometric expression of kappa and lambda, serum albumin, creatinine, calcium, serum free light chain levels and ratio and plasma cell %in BM.