Superior detection rate of plasma cell FISH using FACS-FISH.

Fluorescence in situ hybridization (FISH) for plasma cell neoplasms (PCNs) requires plasma cell (PC) identification or purification strategies to optimize results. We compared the efficacy of cytoplasmic immunoglobulin FISH (cIg-FISH) and fluorescence-activated cell sorting FISH (FACS-FISH) in a clinical laboratory setting. The FISH analysis results of 14,855 samples from individuals with a suspected PCN subjected to cytogenetic evaluation between 2019 and 2022 with cIg-FISH (n = 6917) or FACS-FISH (n = 7938) testing were analyzed. Fluorescence-activated cell sorting-FISH increased the detection rate of abnormalities in comparison with cIg-FISH, with abnormal results documented in 54% vs 50% of cases, respectively (P < .001). It improved the detection of IGH::CCND1 (P < .001), IGH::MAF (P < .001), IGH::MAFB (P < .001), other IGH rearrangements (P < .001), and gains/amplifications of 1q (P < .001), whereas the detection rates of IGH::FGFR3 fusions (P = .3), loss of 17p (P = .3), and other abnormalities, including hyperdiploidy (P = .5), were similar. Insufficient PC yield for FISH analysis was decreased between cIg-FISH and FACS-FISH (22% and 3% respectively, P < .001). Flow cytometry allowed establishment of ploidy status in 91% of cases. In addition, FACS-FISH decreased analysis times, workload efforts, and operating costs. Fluorescence-activated cell sorting-FISH is an efficient PC purification strategy that affords significant improvement in diagnostic yield and decreases workflow requirements in comparison with cIg-FISH. © The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Citation

Marie-France Gagnon, Sally M Midthun, James A Fangel, Cynthia M Schuh, Ivy M Luoma, Kathryn E Pearce, Reid G Meyer, Sikander Ailawadhi, Mariano J Arribas, Esteban Braggio, Rafael Fonseca, S Vincent Rajkumar, Cinthya Zepeda-Mendoza, Xinjie Xu, Patricia T Greipp, Michael M Timm, Gregory E Otteson, Min Shi, Dragan Jevremovic, Horatiu Olteanu, Jess F Peterson, Rhett P Ketterling, Shaji Kumar, Linda B Baughn. Superior detection rate of plasma cell FISH using FACS-FISH. American journal of clinical pathology. 2024 Jan 04;161(1):60-70

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PMID: 37658775

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