Phagocyte Function Decreases after High-Dose Treatment with Melphalan and Autologous Stem Cell Transplantation in Patients with Multiple Myeloma

Experimental Hematology
Stina WichertMarkus Hansson

Abstract

High-dose melphalan with autologous hematopoietic stem cell transplantation (ASCT) is standard of care for younger newly diagnosed multiple myeloma patients, with the aim of achieving as deep and complete response as possible after various combinations of induction therapy. However, it is frequently associated with infectious complications. This study investigated the effects of high-dose treatment with autologous stem cell support on patients' innate immunity, with a focus on subpopulations and functioning of recently released polymorphonuclear leukocytes (PMNs) and monocytes in peripheral blood. Flow cytometry-based analysis was used to measure the degree of PMN maturation and activation, before and after ASCT and compared to healthy controls. After high-dose treatment and ASCT, a smaller proportion of patients' PMNs had capacity for oxidative burst. Moreover, patients' PMNs, both before and after ASCT, showed reduced capacity for phagocytosis. Eosinophils, which recently have been suggested to play a role in promoting malignant plasma cell proliferation, were markedly reduced after ASCT, with slow regeneration. HLA-DR expression by monocytes was significantly depressed after ASCT, a characteristic often attributed to monocyt...Continue Reading

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