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Blood, Vol. 94 No. 2 (July 15), 1999:
pp. 701-712
Reactive Plasmacytoses Are Expansions of Plasmablasts Retaining the
Capacity to Differentiate Into Plasma Cells
Gaëtan Jego,
Nelly Robillard,
Denis Puthier,
Martine Amiot,
Françoise Accard,
Danielle Pineau,
Jean-Luc Harousseau,
Régis Bataille, and
Catherine Pellat-Deceunynck
From INSERM U463, Laboratoire Central d'Hématologie, Institut
de Biologie, Service d'Hématologie Clinique, Hôtel-Dieu,
Nantes, France.
Circulating plasma cells in 10 cases of reactive plasmacytosis had a
shared phenotype with early plasma cell (CD19+
CD38+ CD138+ CD40+
CD45+ CD11a+ CD49e
CD56). In most cases, a minor subpopulation of
CD28+ plasma cells was also detected. Reactive plasma
cells were highly proliferative, suggesting the presence of circulating
progenitors (plasmablasts). After CD138+ plasma cell
removal, highly proliferative CD138 plasmablasts
differentiated into CD138+ plasma cells within a few
days. This differentiation, which was associated with increased CD38
and decreased HLA-DR expression, was further confirmed by a large
increase in intracellular Ig content (associated with Ig secretion) and
was concomitant with extensive secretion of interleukin-6 (IL-6). The
addition of neutralizing anti-IL-6 and anti-CD126 (IL-6 receptor)
monoclonal antibodies totally prevented Ig secretion and cell
differentiation by inducing apoptosis of plasmablasts, which indicates
that IL-6 is an essential survival factor for plasmablasts. This report
provides the first characterization of normal plasmablasts and shows
that their phenotype is not exactly that of multiple myeloma cells.
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