Original Research

Higher proportion of non-classical and intermediate monocytes in newly diagnosed multiple myeloma patients in Egypt: A possible prognostic marker

Asmaa M. Zahran, Hanaa Nafady-Hego, Sawsan M. Moeen, Hanan A. Eltyb, Mohammed M. Wahman, Asmaa Nafady
African Journal of Laboratory Medicine | Vol 10, No 1 | a1296 | DOI: https://doi.org/10.4102/ajlm.v10i1.1296 | © 2021 asmaa nafady | This work is licensed under CC Attribution 4.0
Submitted: 09 June 2020 | Published: 25 August 2021

About the author(s)

Asmaa M. Zahran, Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
Hanaa Nafady-Hego, Department of Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
Sawsan M. Moeen, Department of Internal Medicine, Clinical Haematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt
Hanan A. Eltyb, Department of Medical Oncology, South Egypt Cancer Institute, Assiut University Assiut, Egypt
Mohammed M. Wahman, Department of Clinical Oncology, South Valley University, Qena, Egypt
Asmaa Nafady, Department of Clinical and Chemical Pathology, Qena Faculty of Medicine, South Valley University, Qena, Egypt

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Background: Interaction between multiple myeloma (MM) cells and proximal monocytes is expected during plasma cell proliferation. However, the role of monocyte subsets in the disease progression is unknown.

Objective: This study evaluated circulating monocyte populations in MM patients and their correlation with disease severity.

Methods: Peripheral monocytes from 20 patients with MM attending Assiut University Hospital in Assiut, Egypt, between October 2018 and August 2019 were processed using a flow cytometry procedure and stratified using the intensity of expression of CD14 and CD16 into classical (CD16CD14++), intermediate (CD16+CD14++), and non-classical (CD16++CD14+) subsets. The data were compared with data from 20 healthy control participants with comparable age and sex.

Results: In patients with MM, the percentage of classical monocytes was significantly lower (mean ± standard error: 77.24 ± 0.66 vs 83.75 ± 0.5), while those of non-classical (12.44 ± 0.5 vs 8.9 ± 0.34) and intermediate (10.3 ± 0.24 vs 7.4 ± 0.29) monocytes were significantly higher when compared with those of controls (all p < 0.0001). Proportions of non-classical and intermediate monocytes correlated positively with serum levels of plasma cells, M-protein, calcium, creatinine and lactate dehydrogenase, and correlated negatively with the serum albumin level. Proportions of classical monocytes correlated positively with albumin level and negatively correlated with serum levels of M-protein, plasma cells, calcium, creatinine, and lactate dehydrogenase.

Conclusion: Circulating monocyte subpopulations are skewed towards non-classical and intermediate monocytes in MM patients, and the intensity of this skewness increases with disease severity.


multiple myeloma; classical monocytes; intermediate monocytes; non-classical monocytes; flow cytometry


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