HematoLogics uses cell enrichment techniques of plasma cells in order to produce a sample that will allow for FISH testing and rearrangement studies. HematoLogics first counts the cells using flow cytometry to determine need. If there are insufficient cells, we use CD138 coded beads or sort on a cell sorter using CD38 to isolate the plasma cell population for further study. FISH needs a certain number of cells to work. After enriching the target cells, HematoLogics goes a step further by counting them on a flow cytometer to be sure the quantity is sufficient. Other labs do not count and can waste time, money and sample by trying to FISH the sample when it will only provide false negative results due to low percentage of target cells. Gene rearrangement studies can also be affected in this way.

In this example 3 clones were identified by “Difference from Normal” multidimensional flow cytometry, HCL, CLL and Abnormal Plasma Cells. Their clonal relationship was determined by B-cell gene rearrangement; however the plasma cells were not of sufficient quantity to run the test. By enriching them by using CD138 MACS beads there were now enough cells to not only perform a gene arrangement but also FISH the sample. Cell sorting was used to separate the HCL from the CLL using FMC7. The oncologist now has a clonal fingerprint of all three populations and the results show 3 independent diseases.