Greipp et al classified myeloma based on morphology of the plasma cells. The authors are from the Mayo Clinic.
|
Chromatin Clumping |
Nucleus |
Nucleus Location |
Cytoplasm |
Myeloma Cell Type |
|
dense |
< 8 microns; nucleolus < 1 micron |
eccentric |
well-developed; prominent hof |
mature |
|
intermediate |
8 - 10 microns; nucleolus <= 2 microns |
eccentric |
abundant with a hof |
intermediate |
|
diffuse |
> 10 microns or nucleolus > 2 microns |
eccentric |
abundant with a hof |
immature |
|
diffuse |
> 10 microns or nucleolus > 2 microns |
concentric |
less abundant; little or no hof |
plasmablast |
Any cell not meeting one of the above criteria is classified as an intermediate myeloma cell. The values listed above fill the gaps in the original categories.
|
Mature Myeloma Cells |
Immature Myeloma Cells |
Plasmablastic Myelomas Cells |
Myeloma Type |
|
> 10% |
< 13% |
< 2% |
mature |
|
see below |
see below |
< 2% |
intermediate |
|
< 10% |
>= 13% |
< 2% |
immature |
|
NA |
NA |
>= 2% |
plasmablastic |
Any pattern not meeting one of the above classifications is classified as intermediate myeloma.
total percent of myeloma cells = 100% =
= (percent mature myeloma cells) + (percent intermediate myeloma cells) + (percent immature myeloma cells) + (percent plasmablastic myeloma cells)
Plasmablastic myeloma has the worst survival. These patients are more likely to have renal failure. The plasma cell labeling index is typically higher than for the other types.
Specialty: Hematology Oncology
ICD-10: ,
