TITLE:
Multiple Myeloma: Modification and Adaptation of Plasma Cell Morphology Algorithm for the Prognosis of Congolese Patient
AUTHORS:
Jean Pierre Mufuta Ntolo, Ritha Nyembu Kibambe, Luc Kapia Lunkamba, Paola Bilonda Kalonji, Blaise Sumbu, Gustave Ilunga Ntita, Jean Marie Mbuyi Muamba, Jérémie Muwonga Madidi, Donatien Kayembe Nzongola
KEYWORDS:
Plasma Cell Morphology Algorithm, Plasma Cell Types, Aberrant Plasma Cells, Immature Plasma Cells, Multiple Myeloma
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.12 No.2,
June
28,
2022
ABSTRACT: Objectives: To determine the multiple myeloma (MM) prognostic
formulas applicable in Congolese with many aberrant and/or immature plasma
cells according to GOASGUEN’s plasma cell morphology algorithm (PMA). Methods: The prospective, observational and descriptive study was carried out at the
Ngaliema Clinic in Kinshasa from July 2016 to December 2019. The variables studied were the plasma cell types and the
prognosis groups according to GOASGUEN and ZANDECKI. The nucleolus, the
chromatin and the N/C ratio of 2 for each plasma cell encountered in multiple
myeloma are examined in order by asking three successive questions as follows:
1) Is the nucleolus present? If yes, we denote 1; if not, note 0; 2) Is the
chromatin thin? If yes, we score 1; if not we score 0; 3) The N/C ratio is greater
than 6, if so, 1 is noted; if not, we note 0. We obtain a number with 3
successive digits preceded by the letter P for each plasma cell. Results: The
overall rate of immature plasma cells and aberrant plasma cells in MM among
Congolese was high at 26.6%. Their integration in the prognostic formulas
showed for group A" = 22 patients, group B" = 5 patients and group
C" = 32 patients. Examination of plasma cell types in the deceased showed
that 14/17 had a P001 plasma cell count ≥ 15%. Conclusion: The high rate
of aberrant and/or immature plasma cells, the P001 plasma cell type at a rate ≥
15%, found mostly in group C" with poor prognosis, are responsible for the
aggressive nature of MM in Congolese Blacks.