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Advancement of multiple myeloma from diagnosis through plateau phase to
progression does not involve a new B-cell clone: evidence from the Ig heavy
chain gene
QM Ralph, MJ Brisco, DE Joshua, R Brown, J Gibson and AA Morley
Department of Haematology, Flinders Medical Centre, Bedford Park, South
Australia.
The Ig heavy chain (IgH) gene was used as a marker to investigate clonal
succession and the origin of the neoplastic cell in multiple myeloma. The
polymerase chain reaction (PCR) was used to amplify a section of the
rearranged IgH gene at diagnosis and at progression in 21 patients who had
exhibited a plateau phase. A monoclonal PCR product was seen for 16 of the
patients and the product present at progression was of the same molecular
weight as that at diagnosis. This finding suggests that the IgH
rearrangement present at diagnosis and progression was the same. This was
confirmed by sequencing the IgH gene in 10 patients. The IgH genes were
found to be hypermutated at diagnosis, but no further hypermutation
occurred during the course of the disease. The results provide evidence
that the neoplastic cell in myeloma may originate as a memory B cell,
plasmablast, or plasma cell, and suggest that progression beyond the
plateau phase is not caused by clonal succession.
Volume 82,
Issue 1,
pp. 202-206,
07/01/1993
Copyright © 1993 by The American Society of Hematology
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