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Monitoring Monoclonal Gammopathies



Slide Images

Slide 2

November 2009

This first slide illustrates some important concepts of plasma cell proliferative diseases. The 3 sections of this slide show a Wright-Giemsa-stained bone marrow with a large number of plasma cells, below that is an immunofluorescent stain for cytoplasmic Kappa light chains showing monoclonality of the plasma cells, and on the right of this slide is a bone scan showing bone lesions resulting from foci of proliferating plasma cells.

The concepts that I want to illustrate are first, the disease resides in the bone marrow and is not uniformly distributed throughout the body. That means that monitoring disease by directly quantitating plasma cells in bone marrow biopsies is problematic. Second, the immunofluorescent micrograph illustrates what plasma cells do best – they synthesize immunoglobulins. The secreted, monoclonal immunoglobulin serves as a tumor marker, which we can measure in the serum and/or urine, and which we use to monitor disease.

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