I was reading my husband's flow cytometry report regarding minimal residual disease (MRD). The CD200 phenotype was listed as "bright positive". I don't think this is good, but his doctors have not mentioned it.
After this report he has had an autologous stem cell transplant (ASCT). I think that can help with MRD?
Can anyone explain "bright positive". And any thoughts as it relates to the specific phenotype CD200?
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Re: CD200 "bright positive" on flow cytometry - meaning?
Also, can anyone explain phenotypes of minimal residual disease? Can they move from "bright positive" to negative after a stem cell transplant?
Re: CD200 "bright positive" on flow cytometry - meaning?
I'm sure you already saw this via other searches, but in case not, there's a bit of info tied to CD200 and EFS regarding high-dose therapy and stem cell transplantation. A quick read indicates that CD200 is an independent prognosis factor for patients with multiple myeloma that could represent a new therapeutic target in multiple myeloma, but the articles were dated 2008 and possibly not so relevant these days - good luck getting more info, I know it's not exactly easy.
Hopefully someone can explain in easy to read terms the significance.
Hopefully someone can explain in easy to read terms the significance.
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pinball - Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2010 MGUS, 2014 Smoldering
- Age at diagnosis: 39
Re: CD200 "bright positive" on flow cytometry - meaning?
I feel like no one wants to tell me this is extremely bad.
Re: CD200 "bright positive" on flow cytometry - meaning?
Hello Irankin:
I have no idea whether or not you are correct that this is really bad with respect to "bright" positive for CD200. What I can tell you is that BMB and FISH testing is a rapidly progressing field. My wife has been in the same center for over the past year. We had switched from another center a little before that. She has had 6 BMB's in that period of time. The terminology has changed two or three times on this printout in that time frame.
So you do need to ask your doctor exactly what this means. Unfortunately, the field is moving so fast (on this issue) that the doctor's or the nurses may not give you good answers, because they do not understand. So you need to be particularly persistent in trying to get a good answer.
I know this does not answer your question, but I think it gives an accurate assessment of some of the new terminology in BMB/FISH testing.
Good luck
I have no idea whether or not you are correct that this is really bad with respect to "bright" positive for CD200. What I can tell you is that BMB and FISH testing is a rapidly progressing field. My wife has been in the same center for over the past year. We had switched from another center a little before that. She has had 6 BMB's in that period of time. The terminology has changed two or three times on this printout in that time frame.
So you do need to ask your doctor exactly what this means. Unfortunately, the field is moving so fast (on this issue) that the doctor's or the nurses may not give you good answers, because they do not understand. So you need to be particularly persistent in trying to get a good answer.
I know this does not answer your question, but I think it gives an accurate assessment of some of the new terminology in BMB/FISH testing.
Good luck
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JPC - Name: JPC
Re: CD200 "bright positive" on flow cytometry - meaning?
The terms "negative," "dim" and "bright positive" are standard terms used in characterizing the degree of fluorecence of a given antigen when measured via flow cytometry (which is the test in the battery of BMB tests that determines the immunophenotype of a patient's myeloma cells). "Immunophenotype" is simply the overall makeup of various antigens on a cell's surface.
You can find an explanation of how specific flow cytometry results are classified here:
http://wiki.clinicalflow.com/Cases/Introduction_to_Flow_Cytometric_Analysis
If you read through the above article, you will find that degree of fluorecence (negative, dim and bright) does convey underlying information about the nature of those specific cells tagged by flow cytometry.
As this relates to your CD200 findings, see the article below:
http://www.ncbi.nlm.nih.gov/pubmed/22180482
In a nut, CD200 is commonly found on myeloma cells in about 70% of cases. However, the above article implies that LOSS of CD200 expression (which is not your situation if CD200 is registering as bright positive) has negative prognostic implications.
You can find an explanation of how specific flow cytometry results are classified here:
http://wiki.clinicalflow.com/Cases/Introduction_to_Flow_Cytometric_Analysis
If you read through the above article, you will find that degree of fluorecence (negative, dim and bright) does convey underlying information about the nature of those specific cells tagged by flow cytometry.
As this relates to your CD200 findings, see the article below:
http://www.ncbi.nlm.nih.gov/pubmed/22180482
In a nut, CD200 is commonly found on myeloma cells in about 70% of cases. However, the above article implies that LOSS of CD200 expression (which is not your situation if CD200 is registering as bright positive) has negative prognostic implications.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: CD200 "bright positive" on flow cytometry - meaning?
Hi Irankin,
You've gotten a great explanation from Multibilly. I have just one thing to add, which maybe is already evident to you.
It sounds like this test was performed to determine if your husband is Minimal Residual Disease Negative now. So since your husband's bone marrow sample showed bright positive for CD200, that is an indication that some myeloma cells are present in the bone marrow sample. Therefore your husband would not be MRD negative at this stage.
But here's hoping he does progress to MRD negative in the future!
Mike
You've gotten a great explanation from Multibilly. I have just one thing to add, which maybe is already evident to you.
It sounds like this test was performed to determine if your husband is Minimal Residual Disease Negative now. So since your husband's bone marrow sample showed bright positive for CD200, that is an indication that some myeloma cells are present in the bone marrow sample. Therefore your husband would not be MRD negative at this stage.
But here's hoping he does progress to MRD negative in the future!
Mike
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
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