Использование многоцветной проточной цитометрии для диагностики макроглобулинемии Вальденстрема

   Макроглобулинемия Вальденстрема – лимфоплазмоцитарная лимфома, морфологическим субстратом которой являются В‑лимфоциты, проплазмоциты, а также плазматические клетки. Всемирная организация здравоохранения для диагностики данного заболевания рекомендует в клинической практике использовать метод многоцветной проточной цитометрии и анализировать такие маркеры, как IgM, Cd19, Cd20, Cd22, Cd25, Cd10, Cd23, Cd103, Cd138. Опираясь на международный и собственный опыт, мы рекомендуем врачам анализировать отдельно опухолевые В‑лимфоциты и плазматические клетки при диагностике макроглобулинемии Вальденстрема, так как иммунофенотипический профиль этих популяций различается. В диагностике такой подход дает более полное представление о вкладе различных субпопуляций в опухолевую массу, а при мониторинге минимальной остаточной болезни помогает обнаружить опухолевый клон, который после терапии преимущественно представлен плазматическими клетками. Мы рекомендуем для иммунофенотипического исследования опухолевого субстрата при макроглобулинемии Вальденстрема использовать антитела к поверхностным и внутриклеточным маркерам, таким как Cd138, Cd38, Cd19, Cd45, Cd20, Cd22, Cd27, cytκ, cytλ и cytIgM.

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