Multiparameter flow cytometry (MFC) has become standard in the management of patients with plasma cell (PC) dyscrasias, and could be considered mandatory in specific areas of routine clinical practice. It plays a significant role during the differential diagnostic work-up because of its fast and conclusive readout of PC clonality, and simultaneously provides prognostic information in most monoclonal gammopathies. Recent advances in the treatment and outcomes of multiple myeloma led to the implementation of new response criteria, including minimal residual disease (MRD) status as one of the most relevant clinical endpoints with the potential to act as surrogate for survival. Recent technical progress led to the development of next-generation flow (NGF) cytometry that represents a validated, highly sensitive, cost-effective and widely available technique for standardized MRD evaluation, which also could be used for the detection of circulating tumor cells. Here we review current applications of MFC and NGF in most PC disorders including the less frequent solitary plasmocytoma, light-chain amyloidosis or Waldenström macroglobulinemia.
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Author contributions and disclosures: M.Z. contributed to the research by fluorescence activated cell sorting, DNA processing and amplification, bioinformatic and following data analysis and wrote the manuscript, G. S. designed and led the bioinformatic analysis, T.Š. designed the research, consulted results and wrote the manuscript, V. F. performed the pathway analysis, Z. CH., K. G. and L.B. contributed to bone marrow preparation and DNA processing, T.
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