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Blood, 15 August 2004, Vol. 104, No. 4, pp. 1151-1158.
Prepublished online as a Blood First Edition Paper on April 22, 2004; DOI 10.1182/blood-2003-11-4079.
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Submitted December 1, 2003
Accepted April 13, 2004
RHAMM expression and isoform balance predicts aggressive disease and poor survival in multiple myeloma
Christopher A Maxwell, Erik Rasmussen, Fenghuang Zhan, Jonathan J Keats, Sophia Adamia, Erin Strachan, Mary Crainie, Ronald Walker, Andrew R Belch, Linda M Pilarski, Bart Barlogie, John Shaughnessy, and Tony Reiman*
Oncology and Medicine, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
Donna and Donald Lambert Laboratory of Myeloma Genetics, Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
* Corresponding author; email: tonyreim{at}cancerboard.ab.ca.
Multiple myeloma (MM) plasma cells (PC) express RHAMM, a hyaluronan binding, cytoskeleton and centrosome protein. The most abundant RHAMM isoforms in MM are full-length RHAMMFL and the splice variant RHAMM-exon4. We separately examined the significance of RHAMM expression, and isoform balance, in two groups of MM patients. In oligonucleotide microarray experiments (n=210, Arkansas), increasing RHAMM mRNA expression in MM PC is strongly associated with osteolytic bone lesions (p<0.001), event-free (p=0.05) and overall survival (p=0.04). Semiquantitative determination of RHAMM isoform expression (Alberta, Canada) utilized capillary electrophoretic detection and measurement of RHAMM-exon4/RHAMMFL RT-PCR products. RHAMM isoforms are rarely expressed concurrently in single MM PC; the pattern of isoform expression, at the single cell level, is approximated in larger numbers of cells by the RHAMM-exon4/ RHAMMFL ratio. Absolute RHAMM expression and the RHAMM-exon4/ RHAMMFL ratio are only partially correlated in MM PC; in cell lines, absolute RHAMM expression is elevated in mitosis while RHAMM ratios remain stable. Temporal examination of MM patients peripheral blood reveals that the RHAMM-exon4/RHAMMFL ratio increases with disease burden. The RHAMM-exon4/RHAMMFL ratio in diagnostic bone marrow samples (n=101, Alberta) is an independent prognostic factor. Thus, expression and splicing of RHAMM are important molecular determinants of disease severity in MM.

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