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Blood, 1 March 2002, Vol. 99, No. 5, pp. 1853-1856
BRIEF REPORT
Immunophenotypic evaluation of the plasma cell compartment in
multiple myeloma: a tool for comparing the efficacy of different
treatment strategies and predicting outcome
Jesús F. San Miguel,
Julia Almeida,
Gema Mateo,
Joan Bladé,
Consuelo López-Berges,
Dolores Caballero,
José Hernández,
María Jesús Moro,
Javier Fernández-Calvo,
Joaquín Díaz-Mediavilla,
Luis Palomera, and
Alberto Orfao
From Servicio de Hematología, Hospital
Clínico Universitario, Salamanca; Centro de Investigación
del Cáncer, Salamanca; Servicio de Citometría,
Universidad de Salamanca; Hospital Clinic i Provincial, Barcelona;
Hospital General, Segovia; Hospital Virgen Blanca, León; Hospital
Clínico Universitario, Valladolid; Hospital Clínico,
Madrid; and Hospital Clínico, Zaragoza, Spain.
Multiparametric immunophenotyping can be a sensitive method
for analyzing the plasma cell (PC) compartment in patients with multiple myeloma because it discriminates between myelomatous and
normal PCs. Using this approach, we compared the efficacy of high-dose
chemotherapy followed by autologous stem cell transplantation (ASCT)
with that of conventional chemotherapy. We found that ASCT provided a
significantly greater reduction in the level of residual tumor PCs and
with better recovery of normal PCs. This profile of coexistence of
normal PCs and myelomatous PCs resembled that observed in monoclonal
gammopathy of undetermined significance. We also found that
treatment-induced changes in the PC compartment correlated with disease
outcome. Thus, patients in whom at least 30% of gated PCs had a normal
phenotype after treatment had a significantly longer progression-free
survival (60 ± 6 months versus 34 ± 12 months;
P = .02).
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