In what scenarios (if ever) would you check peripheral blood flow cytometry in a patient with known multiple myeloma to evaluate for circulating plasma cells (CPCs) in the absence of an abnormal smear?

There are some retrospective data that CPCs are associated with worsened outcomes after transplantation. Anecdotally, CPCs could be collected as part of stem cell or T-cell collection. In the (rare) patient with symptoms suspicious for CNS involvement, perhaps CPCs would be helpful to know about before an LP. Would you ever check it?

Answer from: Medical Oncologist at Academic Institution

The question alludes to the fact that there is substantial data now on the prognostic implications of circulating plasma cells at diagnosis. Jelinek et al., PMID 36315921 showed that 2%+ CPCs are associated with a plasma cell leukemia-like phenotype. Much lower levels of CPCs were also associated wi...

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Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
EXCELLENTLY stated - thank you, @Ben! Good to see ...

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In what scenarios (if ever) would you check peripheral blood flow cytometry in a patient with known multiple myeloma to evaluate for circulating plasma cells (CPCs) in the absence of an abnormal smear?

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