EFFECT OF PLASMA CELLS PERCENTAGE AND PATTERN OF INFILTRATION ON HEMATOLOGICAL

Abstract

Introduction: Anemia has been documented in more than two thirds patients of myeloma. There are multiple reasons for this, some of which comprise anemia of chronic disorders, reduced erythropoietin production, decreased sensitivity of erythroid precursors and myeloma cell mediated apoptosis of erythroid progenitors. Crowding of marrow by plasma cells and replacement of marrow interferes with hematopoiesis and is also accountable for anemia.

Objective: To see the effect of percentage and pattern of infiltration of plasma cells on various hematological parameters.

Material and Methods: Prospective study, conducted in Department of Pathology, Pakistan Institute of Medical Sciences Islamabad, for a period of 2 years. Total 78 patients were included in the study. Patients having increased plasma cells on bone marrow aspirate were included in this study. Patients with history of chemotherapy, nutritional deficiency or any other comorbid were excluded in this study. Patients were categorized according to number of plasma cells on bone marrow aspirate as: 5 – 20%, 21 – 30%, 31 – 40%, 41 – 50%, 51-60%, 61 – 70%, 71 – 80%, >80%. Patients were also categorized according to pattern of infiltration on bone marrow trephine biopsy as: Focal, interstitial and diffuse patterns.

Results: A total of 78 patients were selected for the study. Male to female ratio was (2:1). Hematological parameters i.e. hemoglobin, red blood cells, white blood cells and platelets etc. were shown to be deranged as number of plasma cells were increasing and pattern of infiltration was focal to diffuse. There was statistically significant difference between hemoglobin, red blood cells and nucleated red blood cells in patients having <10% and >10% plasma cells on bone marrow aspiration.

Key Words: Plasma cells, plasma cell dyscrasia, Hematological parameters, Bone marrow biopsy, Infiltration.