Name: interphase fluorescence in situ hybridization of bone marrow smears of multiple myeloma
Uploaded: 2022-04-15T14:00:00.000+00:00
Duration: 7 min 53 s
Description: Watch this Scientific Journal Video about Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma at JoVE.com

This project was supported by the Innovation Fund of WNLO 2018WNLOKF023.

This study was conducted according to the principles of the Helsinki Declaration and approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (No. 2019065). The specimens were collected from a MM patient in the Department of Hematology, Zhongnan Hospital of Wuhan University (China).
1. Preparation of the BM smears
<ol>
	<li>Place the first 0.2 mL of BM solution on a clean disposable glass slide.</li>
	<li>Spread the BM smears to uniform thickness with sharp tails by quickly removing the BM. Then, dry naturally.</li>
	<li>Cover the BM films with 1 mL of Wright-Giemsa solution for approximately 10 s at room temperature.</li>
	<li>Add 1 mL of phosphate buffer to the slides. 
	NOTE: Take care to prevent the dye solution from drying or &#64258;owing off the slides.</li>
	<li>Mix the dye solution gently and maintain it for 15 min at room temperature.</li>
	<li>Rinse the slides with clean water and dry them in air at room temperature.</li>
	<li>Use forward light microscopy to detect malignant PCs. The PCs should be well dispersed.</li>
</ol>
2. FISH pre-processing of the BM smears
<ol>
	<li>Cover the hybridized area with fixative solution for 10 min to discolor and fix the PCs.
	<ol>
		<li>To prepare fresh fixative solution, mix methanol with glacial acetic acid in a volume ratio of 3:1.</li>
	</ol>
	</li>
	<li>Rinse the slide with deionized water (dH2O) and dry it in air at room temperature.</li>
	<li>Preheat a jar containing 2x SSC buffer to 56 &#176;C in a water bath. Freshly dilute the buffer to 20x SSC before use.
	<ol>
		<li>To prepare 20x SSC, thoroughly mix 176 g of sodium chloride and 88 g of sodium citrate with 800 mL of dH2O. Measure the pH and adjust to pH 5.3 &#177; 0.2. Then, add dH2O to bring the final volume to 1 L.</li>
	</ol>
	</li>
	<li>Wash the prepared BM smear in the preheated 2x SSC buffer for 10 min, followed by dipping it into deionized water at room temperature.</li>
	<li>Dehydrate the smear in an ethanol gradient (70%, 85%, and 100% ethanol, each for 1 min). Air-dry the smear for 10 min.</li>
</ol>
3. BM smear FISH and washing
NOTE: All steps were performed in a dark room to prevent fluorescence quenching.
<ol>
	<li>Add the TP53/centromere of chromosome 17 (CEP17) probe mixture to the hybridization area and cover it with a coverslip. Press gently with fine-pointed tweezers to remove air bubbles from underneath.</li>
	<li>Seal all sides of the coverslip with rubber cement to ensure good tightness.</li>
	<li>After solidification of the rubber cement, place the slide on an automatic FISH machine. Perform denaturation at 78 &#176;C for 5 min, followed by hybridization at 37 &#176;C overnight.</li>
	<li>Pick up the slide from the FISH machine. Use fine-pointed tweezers to remove the rubber cement gently.</li>
	<li>Immerse the slide in 2x SSC at room temperature for approximately 1 or 2 min to wash the coverslip off.</li>
	<li>Wash the slide in 68 &#176;C preheated 0.4x SSC/0.3% NP-40 buffer in a water bath for 2 min.
	<ol>
		<li>Prepare 0.4x SSC/0.3% NP-40 solution by thoroughly mixing 20 mL of 20x SSC (pH 5.3) with 950 mL of dH2O. Then, add 3 mL of NP-40 and mix thoroughly until completely dissolved. Measure the pH and adjust to 7.0-7.5 with NaOH. Then, add dH2O to bring the final volume of the total solution to 1 L.</li>
	</ol>
	</li>
	<li>Wash the slides with 2x SSC in a 37 &#176;C water bath for 1 min. Set upright in the dark to dry thoroughly for 10 min.</li>
	<li>Add 10 &#181;L of DAPI to the hybridized area and cover with a coverslip.</li>
</ol>
4. FISH analysis and imaging
<ol>
	<li>View the hybridized slide using a suitable filter set on a fluorescence microscope.</li>
	<li>Use a monochromatic blue fluorophore optical filter to observe the fluorescence intensity of the cell nucleus. Take cell nucleus images under a DAPI filter set.</li>
	<li>Use a chromosome centromere probe to show how many chromosomes a cell contains. Label CEP17 with green fluorescence. Use a spectrum green fluorophore optical filter to observe the location of CEP17. Take a CEP17 signals image under the green filter set.</li>
	<li>Label the TP53 gene with orange fluorescence. Use a spectrum orange fluorophore optical filter to observe TP53. Take a TP53 signals image under this set.</li>
	<li>Merge these three images and examine them for numerical abnormalities. 
	NOTE: In a normal interphase cell, two orange and two green signals are observed inside a nucleus with blue fluorescence, indicating one pair of normal chromosome 17 (Figure 1).</li>
</ol>

<ol>
	<li>Sonneveld, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+multiple+myeloma+with+high-risk+cytogenetics:+a+consensus+of+the+International+Myeloma+Working+Group.">Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group.</a> Blood. 127, 2955-2962 (2016).</li><li>Radbruch, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Competence+and+competition:+the+challenge+of+becoming+a+long-lived+plasma+cell.">Competence and competition: the challenge of becoming a long-lived plasma cell.</a> Nature Reviews Immunology. 6, 741-750 (2006).</li><li>Lai, J. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+cytogenetics+in+multiple+myeloma:+a+study+of+151+patients+including+117+patients+at+diagnosis.">Improved cytogenetics in multiple myeloma: a study of 151 patients including 117 patients at diagnosis.</a> Blood. 85 (9), 2490-2497 (1995).</li><li>Hallek, M., Bergsagel, P. L., Anderson, K. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+myeloma:+increasing+evidence+for+a+multistep+transformation+process.">Multiple myeloma: increasing evidence for a multistep transformation process.</a> Blood. 91, 3-21 (1998).</li><li>Munsh, N. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Consensus+recommendations+for+risk+stratification+in+multiple+myeloma:+report+of+the+International+Myeloma+Workshop+Consensus+Panel+2.">Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2.</a> Blood. 117, 4696-4700 (2011).</li><li>Gole, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=cIg-FISH+On+Patients+with+Multiple+Myeloma+-+A+Modified+and+Simple+Technique+Easily+Incorporated+Into+Routine+Clinical+Service.">cIg-FISH On Patients with Multiple Myeloma - A Modified and Simple Technique Easily Incorporated Into Routine Clinical Service.</a> Blood. 120, 4792-4792 (2012).</li><li>Lee, S. H., Erber, W., Porwit, A., Tomonaga, M., Peterson, L. I. C. S. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hematology,+ICSH+guidelines+for+the+standardization+of+bone+marrow+specimens+and+reports.">Hematology, ICSH guidelines for the standardization of bone marrow specimens and reports.</a> International Journal of Laboratory Hematology. 30, 349-364 (2008).</li><li>&#352;tifter, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Combined+evaluation+of+bone+marrow+aspirate+and+biopsy+is+superior+in+the+prognosis+of+multiple+myeloma.">Combined evaluation of bone marrow aspirate and biopsy is superior in the prognosis of multiple myeloma.</a> Diagnostic Pathology. 5, 30 (2010).</li><li>Huegel, A., Coyle, L., McNeil, R., Smith, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+interphase+fluorescence+in+situ+hybridization+on+direct+hematological+bone+marrow+smears.">Evaluation of interphase fluorescence in situ hybridization on direct hematological bone marrow smears.</a> Pathology. 27, 86-90 (1995).</li><li>Jacobsson, B., Bernell, P., Arvidsson, I., Hast, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Classical+morphology,+esterase+cytochemistry,+and+interphase+cytogenetics+of+peripheral+blood+and+bone+marrow+smears.">Classical morphology, esterase cytochemistry, and interphase cytogenetics of peripheral blood and bone marrow smears.</a> The Journal of Histochemistry and Cytochemistry. 44, 1303-1309 (1996).</li><li>Dunning, K., Safo, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+ultimate+Wright-Giemsa+stain:+60+years+in+the+making.">The ultimate Wright-Giemsa stain: 60 years in the making.</a> Biotechnic &amp; Histochemistry. 86, 69-75 (2011).</li><li>Woronzoff-Dashkoff, K. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+wright-giemsa+stain.+Secrets+revealed.">The wright-giemsa stain. Secrets revealed.</a> Clinics in Laboratory Medicine. 22, 15-23 (2002).</li><li>McPherson, R. A., Pincus, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Henry's+Clinical+diagnosis+and+Management+by+Laboratory+Methods+E-book.">Henry's Clinical diagnosis and Management by Laboratory Methods E-book.</a> Elsevier Health Sciences. , (2017).</li><li>Ross, F. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Report+from+the+European+Myeloma+Network+on+interphase+FISH+in+multiple+myeloma+and+related+disorders.">Report from the European Myeloma Network on interphase FISH in multiple myeloma and related disorders.</a> Haematologica. 97, 1272-1277 (2012).</li></ol>

The authors have nothing to disclose.

The application of FISH to genetic risk stratification in MM is essential. The critical part of FISH reports is not all nucleated cells, but clonal PCs specifically purified or identified by sorting with anti-CD138 magnetic beads or marking with cytoplasmic immunoglobulin light chain &#954; or &#955;. Interphase FISH after PC sorting or cIg-FISH was found to be significant in the diagnosis of MM due to the relatively lower proportion of PCs in the BM. However, these methods have some shortcomings, including complex processes, high specimen demands, and high experimental costs. Fifty PCs can be quickly located by a microscope-stage Vernier caliper. BM smears are much easier to obtain than anticoagulant BM specimens because obtaining anti-coagulated BM requires complex procedures to obtain the nucleus. Accordingly, we established a convincing method for BM smear FISH for the detection of MM cells.
First, BM smears should be made by an experienced morphological analyst. To spread the BM into smears, the spreader is placed in front of the aspirate at an angle of 30&#176;-45&#176; and pulled back to make contact with the fluid11. Then, the spreader is moved forward uniformly in a steady motion. The density of the BM smear must be tailored so that the length is approximately three-fourths of the slide12. The BM film must be narrower than the slide to guarantee that cells on all edges can be detected13. The selection of the hybridization area and the localization of PCs was critical in our protocol, and this requires an experienced morphological analyst. For BM smears containing fewer PCs, the PCs should be localized by using a forward fluorescence microscope oil immersion objective and Vernier calipers on the objective stage, and their images can be taken by monochrome shots. For example, if the PCs accounted for only 3% of the total nucleated cells in a BM film by morphological examination, a well-dispersed hybrid region of 8 mm x 8 mm should contain no less than 50 PCs for a FISH test. After FISH hybridization, fluorescence signals in at least 50 PCs must be counted by an experienced analyst14.
However, a limitation of this technique is the requirement for fresh BM smears. If the BM smears are stored for over 2 years, the resulting FISH images might be obscure, resulting in misinterpretation. 
Taken together, the abovementioned BM smear FISH can be extensively used for patients with hematological malignancies when BM extraction is difficult or BM dry tap occurs, even in hypo-proliferative diseases with fewer nucleated cells. We hope that more patients with hematological malignancies can benefit from this method.

Multiple myeloma (MM) is a malignant plasma cell (PC) disease with strong biological heterogeneity and large individual differences in clinical efficacy, with survival periods ranging from months to decades. Cytogenetic characteristics are important prognostic indicators of MM. The risk stratification system and individualized treatments based on genetic characteristics have become topics of intense interest in clinical research on MM1. The aberrations of PCs tested in a fluorescence in situ hybridization (FISH) panel of bone marrow (BM) include del 13q14 (RB1), del 17p13 (TP53), t(4;14) (IGH/FGFR3), t(11;14) (IGH/MYEOV), t(14;16) (IGH/MAF), t(14:20) (IGH/MAFB), 1q21 (CKS1B) gain/amplification, and 1p (CDKN2C) deletion.
Standard metaphase cytogenetics should be included in the initial assessment of MM patients. Although conventional G-banded karyotyping offers the benefit of a whole-chromosome analysis, the low yield of this method leads to many false negative results2. Traditionally, PCs have been viewed as largely incapable of splitting because they are the end-stage products of B lymphocyte differentiation. This makes it difficult to obtain split images. Improved cytogenetic analysis in MM with long-term cultures (6 days) and stimulation of cultures by cytokines may be a promising method for identifying cytogenetic abnormalities in newly diagnosed MM patients3. Even when the culture time was prolonged to 6 days, however, cytogenetic abnormalities were accurately reported in 30%-50% of MM patients4. Furthermore, MM is characterized by complex cytogenetic aberrations that reflect its prognostic heterogeneity. However, the resolution of traditional chromosome banding technology is low, which may easily lead to missed detection of chromosomal abnormalities in MM.
Interphase FISH, preferably after CD138-positive magnetic bead-based PC sorting or marking with cytoplasmic immunoglobulin light chain &#954;/&#955;, is indispensable in the analysis of MM5,6. A CD138-positive selected sample is strongly recommended for the optimized yield of tumor cells. However, accurate quantitation of cytogenetic aberrations requires at least 4 mL of anticoagulated BM for PC sorting. Additionally, the combinations of either CD138 immunomagnetic bead sorting with FISH or cytoplasmic &#954;/&#955; light chain immunoglobulin with FISH testing (cIg-FISH) increase numerous experimental costs and are time-consuming.
Usually, the PC ratio is first assessed from the morphological examination of stained BM smears or BM biopsy sections7,8. BM specimens of the highest quality (first marrow aspirate samples) are used for morphological testing, whereas those sent for FISH or other detection are often the secondary aspirate samples with high ratios of dilution with peripheral blood.
As early as the 1990s, multiple studies showed that BM smears can be directly used for interstitial FISH examinations, which has proven to be a reliable and repeatable method9. An elegant study based on cell morphology and esterase cytochemistry combined with FISH of peripheral blood and BM smears confirmed its great clinical significance for elucidating chromosomal abnormalities in patients with granulocytic and lymphocytic leukemia10.
Herein, we provide a novel method for improving the success of interphase FISH detection in MM patients.

<table><tbody><tr><td>automatic FISH machine</td><td>Leica&amp;nbsp; Corporation</td><td>S500-24</td><td>FINAL Assy Thermobrite 240V</td></tr><tr><td>DAPI</td><td>Abbott Molecular Inc.</td><td>06J49-001</td><td>DAPI Counterstain</td></tr><tr><td>FISH Analysis Software</td><td>IMSTAR&amp;nbsp; Corporation</td><td>IMSTAR</td><td>FISH Analysis Software</td></tr><tr><td>FISH Probe</td><td>Abbott Molecular Inc.</td><td>05N56-020</td><td>Vysis Locus Specifc Identifer TP53 / CEP 17 FISH Probe Kit</td></tr><tr><td>Fixed volume pipette</td><td>Eppendorf China Ltd.</td><td>M33768H</td><td>10&amp;nbsp; microliter</td></tr><tr><td>Fluorescence Microscope</td><td>Olympus Corporation</td><td>BX53</td><td>Forward Fluorescence Microscope</td></tr><tr><td>Karyotype Analysis Software</td><td>IMSTAR&amp;nbsp; Corporation</td><td>IMSTAR</td><td>Karyotype Analysis Software</td></tr><tr><td>Light Microscope</td><td>Olympus&amp;nbsp; Corporation</td><td>BX41</td><td>Forward Light Microscope</td></tr><tr><td>NP-40</td><td>Abbott Molecular Inc.</td><td>07J05-001</td><td>NP-40</td></tr><tr><td>Plastic staining dyeing rack</td><td>Guangzhou Kaixiu Trading Co., Ltd.</td><td>RSJ-501</td><td>&amp;nbsp;24 slides</td></tr><tr><td>Plastic staining dyeing tank</td><td>Guangzhou Kaixiu Trading Co., Ltd.</td><td>RSJ-516</td><td>&amp;nbsp;24 slides</td></tr><tr><td>Rubber Cement</td><td>Marabu&amp;nbsp;GmbH &amp;amp; Co. KG</td><td>FixoGum&amp;nbsp;</td><td>Rubber Cement</td></tr><tr><td>SSC</td><td>Abbott Molecular Inc.</td><td>02J10-032</td><td>20&amp;times;SSC</td></tr><tr><td>Water bath</td><td>Shanghai Boxun Medical Bio-Instrument Co., Ltd.</td><td>DK-8D</td><td>Multiple Temperature Water bath</td></tr></tbody></table>

interphase fluorescence in situ hybridization of bone marrow smears of multiple myeloma

Fluorescence in situ hybridization (FISH) detection is an indispensable method in genetic risk stratification in multiple myeloma (MM), which is one of the most common hematological malignancies. The identifying characteristic of MM is accumulated malignant plasma cells in bone marrow. FISH reports for MM mainly focus on purified or identified clonal plasma cells, rather than all nucleated cells, by sorting with anti-CD138 magnetic beads or marking with cytoplasmic immunoglobulin light chain &#954; or &#955;. Bone marrow interphase nuclei are usually obtained from fresh bone marrow cells. However, satisfactory enrichment of plasma cell specimens requires large amounts of fresh heparin anti-coagulated bone marrow, which cannot be obtained in the case of difficult bone marrow extraction or a bone marrow dry tap. Herein, we establish a novel method to improve the success of FISH detection on stained or unstained bone marrow smears. Bone marrow smears are easier to obtain than anticoagulated bone marrow specimens.

In the initial morphological assessment of a newly diagnosed MM patient, 15% of PCs in a BM smear were found to have larger and darker nuclei along with larger amounts of cytoplasm than normal PCs (Figure 2A). The first tube of heparin anti-coagulated BM detected by the immunophenotype technique revealed only 2.3% of the monoclonal aberrant PCs. CD138 immunomagnetic bead sorting in combination with FISH or the cIg-FISH technique is essential for obtaining an accurate FISH result. However, aspirated BM is limited in the event of it being a dry tap. BM smears were used to test interphase FISH. A representative binucleated PC in BM film was localized by a fluorescence microscope stage Vernier caliper (Figure 2B). FISH was applied to the BM smears to test&#160;for TP53 and CEP17. The FISH results showed four orange and four green signals in one interphase PC nucleus (Figure 2C), suggesting that four copies of chromosome 17 were localized in the metaphase PC nuclei. Karyotyping results were obtained by extending the culture time up to 3 days and further analyzed using FISH analytic software (Figure 2D). The accuracy of the interphase FISH results on the BM smears was further verified.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/63083/63083fig01.jpg" /> 
Figure 1: Normal signals of the TP53/CEP17 FISH probe for interphase cells (1000x). The fluorescence intensity of the cell nucleus was blue, the TP53 was orange, and the CEP17 was green. In those 3 normal interphase cells, both two orange and two green signals appeared inside the blue-fluorescing nucleus, indicating two pairs of the normal chromosome 17. <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/63083/63083fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/63083/63083fig02.jpg" /> 
Figure 2: Morphology and genetic images of bone marrow (BM) in multiple myeloma (MM) patients. (A) Myeloma cells with clustered distribution indicated by the arrows (<img alt="Equation 1" src="/files/ftp_upload/63083/63083eq01v2.jpg" style="margin: auto;" />) after Wright-Giemsa staining of the BM smear (1000&#215;). (B) Binucleate plasmacytoid cells indicated by arrows (<img alt="Equation 2" src="/files/ftp_upload/63083/63083eq02.jpg" style="margin: auto;" />) on a grayscale image taken by a black and white camera on a fluorescence microscope (1000&#215;). (C) TP53/ centromere of chromosome 17 (CEP17) fluorescence in situ hybridization (FISH) probe test for the BM smear. FISH reveals four TP53 and four CEP17 signals in each nucleus (&#8594;) (1000&#215;). (D) Abnormal chromosome karyogram shows two pairs of chromosome 17 in one nucleus (<img alt="Equation 3" src="/files/ftp_upload/63083/63083eq03v2.jpg" style="margin: auto;" />). <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/63083/63083fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>

Watch this Scientific Journal Video about Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma at JoVE.com

Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma

Here, we present a protocol for improving the success of interphase fluorescence in situ hybridization detection on bone marrow smears from multiple myeloma patients.

Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma

Fluorescence in situ hybridization (FISH) detection is an indispensable method in genetic risk stratification in multiple myeloma (MM), which is one of ...

interphase-fluorescence-situ-hybridization-bone-marrow-smears

Nanyang Technological University

Research

JoVE Journal

Medicine

4.1K Views.  Zhongnan Hospital of Wuhan University. De toepassing van fluorescentie in situ hybridisatie genaamd FISH op genetische risicostratificatie bij multipel myeloom is essentieel. Het kritieke deel van FISH-rapporten zijn niet alle kerncellen, maar klonale plasmacellen die specifiek zijn gezuiverd of geïdentificeerd door te sorteren met anti-CD138 magnetische kralen of te markeren met cytoplasmatische kappa of Lambda lichte keten immunoglobuline met FISH-testen genaamd cIg FISH. Interfase FISH na plasmacelsortering of cIg FISH blijkt ...

Video: Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma

Detection of Inter-chromosomal Stable Aberrations by Multiple Fluorescence In Situ Hybridization (mFISH) and Spectral Karyotyping (SKY) in Irradiated Mice

Ionizing radiation (IR) induces numerous stable and unstable chromosomal aberrations. Unstable aberrations, where chromosome morphology is substantially compromised, can easily be identified by conventional chromosome staining techniques. However, detection of stable aberrations, which involve exchange or translocation of genetic materials without considerable modification in the chromosome morphology, requires sophisticated chromosome painting techniques that rely on in situ hybridization of fluorescently labeled DNA probes, a chromosome painting technique popularly known as fluorescence in situ hybridization (FISH). FISH probes can be specific for whole chromosome/s or precise sub-region on chromosome/s. The method not only allows visualization of stable aberrations, but it can also allow detection of the chromosome/s or specific DNA sequence/s involved in a particular aberration formation. A variety of chromosome painting techniques are available in cytogenetics; here two highly sensitive methods, multiple fluorescence in situ hybridization (mFISH) and spectral karyotyping (SKY), are discussed to identify inter-chromosomal stable aberrations that form in the bone marrow cells of mice after exposure to total body irradiation. Although both techniques rely on fluorescent labeled DNA probes, the method of detection and the process of image acquisition of the fluorescent signals are different. These two techniques have been used in various research areas, such as radiation biology, cancer cytogenetics, retrospective radiation biodosimetry, clinical cytogenetics, evolutionary cytogenetics, and comparative cytogenetics.

Detection of Inter-chromosomal Stable Aberrations by Multiple Fluorescence In Situ Hybridization mFISH and Spectral Karyotyping SKY in Irradiated Mice

The present protocol describes the usefulness of multiple fluorescence in situ hybridization (mFISH) and spectral karyotyping (SKY) in identifying inter-chromosomal stable aberrations in the bone marrow cells of mice after exposure to total body irradiation.

Ionizing radiation (IR) induces numerous stable and unstable chromosomal aberrations. Unstable aberrations, where chromosome morphology is substantially ...

Genetics

Multimodal Bioluminescent and Positronic-emission Tomography/Computational Tomography Imaging of Multiple Myeloma Bone Marrow Xenografts in NOG Mice

Multiple myeloma (MM) tumors engraft in the bone marrow (BM) and their survival and progression are dependent upon complex molecular and cellular interactions that exist within this microenvironment. Yet the BM microenvironment cannot be easily replicated in vitro, which potentially limits the physiologic relevance of many in vitro and ex vivo experimental models. These issues can be overcome by utilizing a xenograft model in which luciferase (LUC)-transfected 8226 MM cells will specifically engraft in the mouse skeleton. When these mice are given the appropriate substrate, D-luciferin, the effects of therapy on tumor growth and survival can be analyzed by measuring changes in the bioluminescent images (BLI) produced by the tumors in vivo. This BLI data combined with positronic-emission tomography/computational tomography (PET/CT) analysis using the metabolic marker 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) is used to monitor changes in tumor metabolism over time. These imaging platforms allow for multiple noninvasive measurements within the tumor/BM microenvironment.

Here we use bioluminescent, X-ray, and positron-emission tomography/computed tomography imaging to study how inhibiting mTOR activity impacts bone marrow-engrafted myeloma tumors in a xenograft model. This allows for physiologically relevant, non-invasive, and multimodal analyses of the anti-myeloma effect of therapies targeting bone marrow-engrafted myeloma tumors in vivo.

Multiple myeloma (MM) tumors engraft in the bone marrow (BM) and their survival and progression are dependent upon complex molecular and cellular ...

Cancer Research

Combining Intravital Fluorescent Microscopy (IVFM) with Genetic Models to Study Engraftment Dynamics of Hematopoietic Cells to Bone Marrow Niches

Increasing evidence indicates that normal hematopoiesis is regulated by distinct microenvironmental cues in the BM, which include specialized cellular niches modulating critical hematopoietic stem cell (HSC) functions1,2. Indeed, a more detailed picture of the hematopoietic microenvironment is now emerging, in which the endosteal and the endothelial niches form functional units for the regulation of normal HSC and their progeny3,4,5. New studies have revealed the importance of perivascular cells, adipocytes and neuronal cells in maintaining and regulating HSC function6,7,8. Furthermore, there is evidence that cells from different lineages, i.e. myeloid and lymphoid cells, home and reside in specific niches within the BM microenvironment. However, a complete mapping of the BM microenvironment and its occupants is still in progress.
Transgenic mouse strains expressing lineage specific fluorescent markers or mice genetically engineered to lack selected molecules in specific cells of the BM niche are now available. Knock-out and lineage tracking models, in combination with transplantation approaches, provide the opportunity to refine the knowledge on the role of specific &#34;niche&#34; cells for defined hematopoietic populations, such as HSC, B-cells, T-cells, myeloid cells and erythroid cells. This strategy can be further potentiated by merging the use of two-photon microscopy of the calvarium. By providing in vivo high resolution imaging and 3-D rendering of the BM calvarium, we can now determine precisely the location where specific hematopoietic subsets home in the BM and evaluate the kinetics of their expansion over time. Here, Lys-GFP transgenic mice (marking myeloid cells)9 and RBPJ knock-out mice (lacking canonical Notch signaling)10 are used in combination with IVFM to determine the engraftment of myeloid cells to a Notch defective BM microenvironment.

Combining Intravital Fluorescent Microscopy IVFM with Genetic Models to Study Engraftment Dynamics of Hematopoietic Cells to Bone Marrow Niches

Intravital fluorescence microscopy (IVFM) of the calvarium is applied in combination with genetic animal models to study the homing and engraftment of hematopoietic cells into bone marrow (BM) niches.

Increasing evidence indicates that normal hematopoiesis is regulated by distinct microenvironmental cues in the BM, which include specialized cellular ...

Developmental Biology

Quantitative Multispectral Analysis Following Fluorescent Tissue Transplant for Visualization of Cell Origins, Types, and Interactions

With the desire to understand the contributions of multiple cellular elements to the development of a complex tissue; such as the numerous cell types that participate in regenerating tissue, tumor formation, or vasculogenesis, we devised a multi-colored cellular transplant model of tumor development in which cell populations originate from different fluorescently colored reporter gene mice and are transplanted, engrafted or injected in and around a developing tumor. These colored cells are then recruited and incorporated into the tumor stroma. In order to quantitatively assess bone marrow derived tumor stromal cells, we transplanted GFP expressing transgenic whole bone marrow into lethally irradiated RFP expressing mice as approved by IACUC. 0ovarian tumors that were orthotopically injected into the transplanted mice were excised 6-8 weeks post engraftment and analyzed for bone marrow marker of origin (GFP) as well as antibody markers to detect tumor associated stroma using multispectral imaging techniques. We then adapted a methodology we call MIMicc- Multispectral Interrogation of Multiplexed cellular compositions, using multispectral unmixing of fluoroprobes to quantitatively assess which labeled cell came from which starting populations (based on original reporter gene labels), and as our ability to unmix 4, 5, 6 or more spectra per slide increases, we&#39;ve added additional immunohistochemistry associated with cell lineages or differentiation to increase precision. Utilizing software to detect co-localized multiplexed-fluorescent signals, tumor stromal populations can be traced, enumerated and characterized based on marker staining.1

Complex tissue masses, from organs to tumors, are composed of various cellular elements. We elucidated the contribution of cellular phenotypes within a tissue utilizing multi-labeled fluorescent transgenic mice in combination with multiparameter immunofluorescent staining followed by spectral unmixing to decipher cell origin as well as cell characteristics based on protein expression.

With the desire to understand the contributions of multiple cellular elements to the development of a complex tissue; such as the numerous cell types that ...

Isolation and Characterization of Bone Marrow Microenvironment in Myeloid Neoplasms

Identifying Bone Marrow Microenvironmental Populations in Myelodysplastic Syndrome and Acute Myeloid Leukemia

The bone marrow microenvironment consists of distinct cell populations, such as mesenchymal stromal cells, endothelial cells, osteolineage cells, and fibroblasts, which provide support for hematopoietic stem cells (HSCs). In addition to supporting normal HSCs, the bone marrow microenvironment also plays a role in the development of hematopoietic stem cell disorders, such as myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). MDS-associated mutations in HSCs lead to a block in differentiation and progressive bone marrow failure, especially in the elderly. MDS can often progress to therapy-resistant AML, a disease characterized by a rapid accumulation of immature myeloid blasts. The bone marrow microenvironment is known to be altered in patients with these myeloid neoplasms. Here, a comprehensive protocol to isolate and phenotypically characterize bone marrow microenvironmental cells from murine models of myelodysplastic syndrome and acute myeloid leukemia is described. Isolating and characterizing changes in the bone marrow niche populations can help determine their role in disease initiation and progression and may lead to the development of novel therapeutics targeting cancer-promoting alterations in the bone marrow stromal populations.

Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies 

Here a detailed protocol to isolate and characterize bone marrow microenvironmental populations from murine models of myelodysplastic syndromes and acute myeloid leukemia is presented. This technique identifies changes in the non-hematopoietic bone marrow niche, including the endothelial and mesenchymal stromal cells, with disease progression.

The bone marrow microenvironment consists of distinct cell populations, such as mesenchymal stromal cells, endothelial cells, osteolineage cells, and ...

An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells

In this work we describe a novel approach that combines ex vivo drug sensitivity assays and digital image analysis to estimate chemosensitivity and heterogeneity of patient-derived multiple myeloma (MM) cells. This approach consists in seeding primary MM cells freshly extracted from bone marrow aspirates into microfluidic chambers implemented in multi-well plates, each consisting of a reconstruction of the bone marrow microenvironment, including extracellular matrix (collagen or basement membrane matrix) and stroma (patient-derived mesenchymal stem cells) or human-derived endothelial cells (HUVECs). The chambers are drugged with different agents and concentrations, and are imaged sequentially for 96 hr through bright field microscopy, in a motorized microscope equipped with a digital camera. Digital image analysis software detects live and dead cells from presence or absence of membrane motion, and generates curves of change in viability as a function of drug concentration and exposure time. We use a computational model to determine the parameters of chemosensitivity of the tumor population to each drug, as well as the number of sub-populations present as a measure of tumor heterogeneity. These patient-tailored models can then be used to simulate therapeutic regimens and estimate clinical response.

We describe a high-throughput drug sensitivity assay for primary multiple myeloma cells. It consists of a reconstruction of the bone marrow microenvironment (including extracellular matrix and stroma) in multi-well plates, and a non-invasive method for longitudinal quantification of cell viability.

In this work we describe a novel approach that combines ex vivo drug sensitivity assays and digital image analysis to estimate chemosensitivity and ...

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

Immunohistochemical (IHC) methods for the in-situ analysis of protein expression by light microscopy are a powerful tool for both research and diagnostic purposes. However, the visualization and quantification of multiple antigens in a single tissue section using conventional chromogenic IHC is challenging. Multiplexed imaging is especially relevant in lymphoma research and diagnostics, where markers have to be interpreted in the context of a complex tumor microenvironment. Here we describe a protocol for multiplexed fluorescent IHC staining to enable the quantitative assessment of multiple targets in specific cell types of interest in lymphoma.The method covers aspects of antibody validation, antibody optimization, the multiplex optimization with markers of lymphoma subtypes, the staining of tissue microarray (TMA) slides, and the scanning of the slides, followed by data analysis, with specific reference to lymphoma. Using this method, scores for both the mean intensity of a marker of interest and the percentage positivity are generated to facilitate further quantitative analysis. Multiplexing minimizes sample utilization and provides spatial information for each marker of interest.

Here we describe a protocol for multiplex fluorescent immunohistochemical staining and imaging for the simultaneous localization of multiple cancer-associated antigens in lymphoma. This protocol can be extended to the colocalization analysis of biomarkers within all tissue sections.

Immunohistochemical (IHC) methods for the in-situ analysis of protein expression by light microscopy are a powerful tool for both research and diagnostic ...

Immunology and Infection

A Rapid Method for Multispectral Fluorescence Imaging of Frozen Tissue Sections

Multispectral fluorescence imaging on formalin-fixed paraffin-embedded (FFPE) tissues enables the detection of multiple markers in a single tissue sample that can provide information about antigen coexpression and spatial distribution of the markers. However, a lack of suitable antibodies for formalin-fixed tissues may restrict the nature of markers that can be detected. In addition, the staining method is time-consuming. Here we describe a rapid method to perform multispectral fluorescence imaging on frozen tissues. The method includes the fluorophore combinations used, detailed steps for the staining of mouse and human frozen tissues, and the scanning, acquisition, and analysis procedures. For staining analysis, a commercially available semiautomated multispectral fluorescence imaging system is used. Through this method, up to six different markers were stained and detected in a single frozen tissue section. The machine learning analysis software can phenotype cells that can be used for quantitative analysis. The method described here for frozen tissues is useful for the detection of markers that cannot be detected in FFPE tissues or for which antibodies are not available for FFPE tissues.

We describe a rapid staining method to perform multispectral imaging on frozen tissues.

Multispectral fluorescence imaging on formalin-fixed paraffin-embedded (FFPE) tissues enables the detection of multiple markers in a single tissue sample ...

Database-guided Flow-cytometry for Evaluation of Bone Marrow Myeloid Cell Maturation

A working group initiated within the French Cytometry Association (AFC) was developed in order to harmonize the application of multiparameter flow cytometry (MFC) for myeloid disease diagnosis in France. The protocol presented here was agreed-upon and applied between September 2013 and November 2015 in six French diagnostic laboratories (University Hospitals of Saint-Etienne, Grenoble, Clermont-Ferrand, Nice, and Lille and Institut Paoli-Calmettes in Marseille) and allowed the standardization of bone marrow sample preparation and data acquisition. Three maturation databases were developed for neutrophil, monocytic, and erythroid lineages with bone marrow from "healthy" donor individuals (individuals without any evidence of a hematopoietic disease). A robust method of analysis for each myeloid lineage should be applicable for routine diagnostic use. New cases can be analyzed in the same manner and compared against the usual databases. Thus, quantitative and qualitative phenotypic abnormalities can be identified and those above 2SD compared with data of normal bone marrow samples should be considered indicative of pathology. The major limitation is the higher variability between the data achieved using the monoclonal antibodies obtained with the methods based on hybridoma technologies and currently used in clinical diagnosis. Setting criteria for technical validation of the data acquired may help improve the utility of MFC for MDS diagnostics. The establishment of these criteria requires analysis against a database. The reduction of investigator subjectivity in data analysis is an important advantage of this method.

The MDS diagnosis is difficult in the absence of morphological criteria or non-informative cytogenetics. MFC could help refine the MDS diagnostic process. To become useful for clinical practice, the MFC analysis must be based on parameters with sufficient specificity and sensitivity, and data should be reproducible between different operators.

A working group initiated within the French Cytometry Association (AFC) was developed in order to harmonize the application of multiparameter flow ...

Intrafemoral Injection for Bone Marrow Study in Live Mice

Simplified Intrafemoral Injections Using Live Mice Allow for Continuous Bone Marrow Analysis

Despite the complexity of hematopoietic cell transplantation in humans, researchers commonly perform intravenous or intrafemoral (IF) injections in mice. In murine models, this technique has been adapted to enhance the seeding efficiency of transplanted hematopoietic stem and progenitor cells (HSPCs). This paper describes a detailed step-by-step technical procedure of IF injection and the following bone marrow (BM) aspiration in mice that allows for serial characterization of cells present in the BM. This method enables the transplantation of valuable samples with low cell numbers that are particularly difficult to engraft by intravenous injection. This procedure facilitates the creation of xenografts that are critical for pathological analysis. While it is easier to access peripheral blood (PB), the cellular composition of PB does not reflect the BM, which is the niche for HSPCs. Therefore, procedures providing access to the BM compartment are essential for studying hematopoiesis. IF injection and serial BM aspiration, as described here, allow for the prospective retrieval and characterization of cells enriched in the BM, such as HSPCs, without sacrificing the mice.

This protocol describes the intrafemoral injection of a few hematopoietic or leukemic stem cells, including gene-edited cells, in murine xenograft models, which will not only enable the quick and safe transplantation of cells but also serial analyses of the bone marrow.

Despite the complexity of hematopoietic cell transplantation in humans, researchers commonly perform intravenous or intrafemoral (IF) injections in mice. ...

Interphase Fluorescence in situ Hybridization of Bone Marrow Smears of Multiple Myeloma

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