One hundred blood samples were analysed on Technicon H1, Technicon H6000, and Coulter VCS hematology analysers, and the white cell differential counts were compared. All three instruments showed very good agreement for neutrophils and lymphocytes, good agreement for eosinophiles, and acceptable agreement for monocytes. For the material analysed there were no disparities of clinical significance between the results obtained from the three instruments.
Monoclonal gammopathies are B lymphocyte-derived disorders producing a specific monoclonal immunoglobulin. The group includes multiple myeloma, Waldenström's macroglobulinaemia, monoclonal gammopathy of undetermined significance (MGUS) and heavy-chain disease. In 1% of the cases a double M-component is present which is referred to as a biclonal gammopathy. The pathogeneses of these disorders are unknown, but several possibly related environmental factors have been identified. In multiple myeloma, an increased incidence and mortality rate has been noted during the last 20 years. Strong lines of evidence are presented showing that, in monoclonal gammopathies, the cell clone consists of B lymphocytes in different stages of maturation. In most cases of biclonal gammopathy there is probably a common cellular origin.
Much less is known about the chromosome changes in MM than in other hematological malignancies. The prevalence of abnormal karyotypes is unknown, but there is no evidence for malignant plasma cells or their precursors to have a normal karyotype. The chromosome changes found may be early events, but karyotypic evolution occurs early and rapidly. No specific structural or numerical chromosome anomaly is associated with multiple myeloma or plasma-cell leukemia. The changes found are those already known to occur in other B-cell malignancies, particularly B-CLL and diffuse small cell lymphoma. A 14Q + marker is present in about 30% of all karyotypically abnormal cases, and in 50% of the cases this is due to a t(11;14) (q13;q32). In a minority of cases deletions of 6q are found, and sporadically other B-cell translocations can be present. Karyotypes are often very complex with numerous structural anomalies involving mainly chromosomes 1, 11 and 17, and numerical anomalies involving chromosomes 3, 7, 9 and 11. Finally, the presence of structural or numerical anomalies of chromosomes 5 and 7 may be heralding or may be indicative of therapy-induced leukemia.
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