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Andrea Mosca
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Matteo Vidali

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Giuseppe Agosta

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BC: Articoli scritti da N. Cecconi

Correlazione tra dati istologici e profili immunofenotipici in pazienti affetti da mieloma multiplo in differente tipo di trattamento
Correlation between bone marrow histology and plasma cell immunophenotyping in patients with multiple myeloma under various treatments
<p>The diagnostic and response criteria of multiple myeloma have been established by the International Myeloma Working Group. Although bone marrow morphology represents the gold standard both in the diagnostic and in the post-therapy practice, the role of multiparameter immunophenotyping by flow cytometry is currently gaining importance. The rapidity and high sensitivity to distinguish normal plasma cells from the pathological ones make this technique a precious tool, especially in defining the therapeutical response and in detecting minimal residual disease. We compared 92 simultaneous patterns of plasma cell immunophenotype and bone marrow morphology of multiple myeloma, after treatment with either chemoterapy alone or high-dose therapy with autologous or allogeneic stem cell transplantation. The aim was to determine the percentage of agreement of the two techniques in establishing the response to treatment. Discordant results were obtained in 6 cases, in which flow cytometry was able to correctly establish the degree of response to therapy. Our study shows the utility of using flow cytometry in response assessment in patients treated for multiple myeloma, with particular reference to patients in apparent complete remission and patients with oligoclonal bands observed after high-dose therapy.</p>
Biochimica Clinica ; 41(1) 072-078
Contributi scientifici - Scientific papers
 
Impiego della citofluorimetria multiparametrica nella valutazione della risposta alla terapia in pazienti con macroglobulinemia di Waldenström
Use of multiparameter flow cytometry in the evaluation of treatment effectiveness in Waldenström macroglobulinemia
Biochimica Clinica ; 40(3) 285-286
Lettere all'Editore - Letters to the Editor
 
Disfibrinogenemia indotta da una catena leggera libera kappa delle immunoglobuline
Ig-free light chains induced dysfibrinogenemia
<p>Despite several pathological conditions are associated with free&nbsp;light chains (FLC) deposition in human tissues, only few cases of human diseases caused by the specific binding&nbsp;activity of monoclonal FLC are described. A 65-year old male patient, with highly abnormal functional coagulation&nbsp;tests and undetectable functional fibrinogen was admitted to the Hematological Clinic of the University Hospital of&nbsp;Pisa. The same tests were within the reference intervals one year before. After excluding a number of causes for&nbsp;abnormal coagulation tests, we focused on potential causes of acquired dysfibrinogenemia. Due to the presence of&nbsp;abnormal values of FLC, we performed an immunofixation: while serum did not show any detectable monoclonal&nbsp;band, the immunofixation of a plasma sample revealed the presence of monoclonal FLC of kappa type co-migrating&nbsp;with fibrinogen. The serum kappa FLC concentrations were much lower than plasma levels, suggesting that the&nbsp;majority of these FLC were bound to fibrinogen, remaining associated to fibrin after clotting. Bone marrow biopsy&nbsp;showed 4% monoclonal plasma cells producing kappa light chains. The patient was diagnosed as affected by a FLC&nbsp;MGUS. After two courses of dexamethasone, the plasma concentration of kappa FLC decreased substantially and&nbsp;most of the coagulation tests normalized. The nature of the interaction between fibrinogen and kappa FLC is currently&nbsp;under investigation to elucidate the mechanism able to inhibit fibrinogen polymerization.</p>
Biochimica Clinica ; 39(5) e16-e18
Casi clinici - Case report