Publication: Plasma cell quantification in bone marrow by computer-assisted image analysis
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Date
2006
Authors
Went, P. ; Mayer, S. ; Oberholzer, M. ; Dirnhofer, S.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Background: Minor and major criteria for the
diagnosis of multiple meloma according to the definition
of the WHO classification include different categories of
the bone marrow plasma cell count: a shift from the 10-
30% group to the >30% group equals a shift from a
minor to a major criterium, while the <10% group does
not contribute to the diagnosis. Plasma cell fraction in
the bone marrow is therefore critical for the
classification and optimal clinical management of
patients with plasma cell dyscrasias. The aim of this
study was (i) to establish a digital image analysis system
able to quantify bone marrow plasma cells and (ii) to
evaluate two quantification techniques in bone marrow
trephines i.e. computer-assisted digital image analysis
and conventional light-microscopic evaluation. The
results were compared regarding inter-observer variation
of the obtained results.
Material and methods: Eighty-seven patients, 28 with
multiple myeloma, 29 with monoclonal gammopathy of
undetermined significance, and 30 with reactive
plasmocytosis were included in the study. Plasma cells
in H&E- and CD138-stained slides were quantified by
two investigators using light-microscopic estimation and
computer-assisted digital analysis. The sets of results
were correlated with rank correlation coefficients.
Patients were categorized according to WHO criteria
addressing the plasma cell content of the bone marrow
(group 1: 0-10%, group 2: 11-30%, group 3: >30%), and
the results compared by kappa statistics.
Results: The degree of agreement in CD138-stained slides was higher for results obtained using the
computer-assisted image analysis system compared to
light microscopic evaluation (corr.coeff.=0.782), as was
seen in the intra- (corr.coeff.=0.960) and inter-individual
results correlations (corr.coeff.=0.899). Inter-observer agreement for categorized results (SM/PW: kappa 0.833)
was in a high range.
Conclusions: Computer-assisted image analysis
demonstrated a higher reproducibility of bone marrow
plasma cell quantification. This might be of critical
importance for diagnosis, clinical management and
prognostics when plasma cell numbers are low, which
makes exact quantifications difficult.
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