Aggressive neoplastic plasma cell growth with MLL gene rearrangement after high-dose therapy with autologous stem cell support for multiple myeloma

Bone Marrow Transplantation
K NishiiH Shiku

Abstract

We report a case of a patient with IgA kappa multiple myeloma (MM) mobilized with etoposide and subsequently receiving high-dose melphalan (HDM) with stem cell support. She relapsed rapidly post transplantation. Southern blot and fluorescent in situ hybridization analysis showed MLL gene rearrangement in the myeloma cells, which was not detected in the sample at diagnosis or in the PBSC harvested with etoposide plus G-CSF. These observations suggest that clonal rearrangement of the MLL gene is caused by etoposide. Patients with MM undergoing HDM with stem cell rescue may be at an increased risk of not only secondary leukemia, but also secondary genetic abnormalities in myeloma cells, especially those receiving priming with etoposide for peripheral blood stem cell collection.

References

Jul 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J M AndrieuG Flandrin
Mar 21, 1996·The New England Journal of Medicine·S BhatiaA T Meadows
Mar 1, 1996·British Journal of Haematology·Y ZhangB Schlegelberger

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