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High-dose sequential chemoradiotherapy in multiple myeloma: residual tumor
cells are detectable in bone marrow and peripheral blood cell harvests and
after autografting
P Corradini, C Voena, M Astolfi, M Ladetto, C Tarella, M Boccadoro and A Pileri
Dipartimento di Medicina ed Oncologia Sperimentale, Universita di Torino,
Italy.
Based on preliminary encouraging results in terms of response rate and
survival, high-dose chemoradiotherapy has gained considerable interest in
the treatment of patients with multiple myeloma (MM). We have evaluated the
presence of residual myeloma cells in 15 of 18 patients enrolled in a
high-dose sequential (HDS) chemoradiotherapy program followed by
autografting. Our analysis has been performed both on bone marrow (BM) and
peripheral blood (PB) cell harvests and after autografting. As it has been
recently shown that B cells clonally related to malignant plasma cells are
detectable in MM patients, we have developed a polymerase chain reaction
(PCR)-based strategy to detect both residual B cells and plasma cells using
clone-specific sequences derived from the rearrangement of Ig heavy chain
(IgH) genes. The complementarity-determining regions (CDR) of IgH genes
have been used to generate tumor-specific primers and probes. The constant
(C) region usage defined the differentiation stage of residual myeloma
cells. We report that plasma cells were detectable in PB and BM cell
harvests and after transplantation in all assessable patients, irrespective
of disease status. B cells were detectable in a consistent proportion of BM
and PB samples at diagnosis, but only in one case at the time of PB and BM
cell harvests. These cells became sometimes detectable after
transplantation. Whether residual myeloma cells are clonogenic and
contribute to relapse is currently unknown, and further investigations are
required.
Volume 85,
Issue 6,
pp. 1596-1602,
03/15/1995
Copyright © 1995 by The American Society of Hematology
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