Serial studies of peripheral blood myeloma cells in patients with multiple myeloma: when is the optimal time for stem cell harvest?

Leukemia & Lymphoma
Thomas E WitzigPhilip R Greipp

Abstract

This study serially quantitated monoclonal plasma cells (PC) in the peripheral blood (PB) of 33 patients with multiple myeloma (MM) at diagnosis, after therapy, and at relapse using a sensitive immunofluorescence technique. The goal was to learn which disease phase is best for harvesting PB stem cells free of monoclonal PC. In 24 chemotherapy responders, 88% (21/24) had circulating PC at diagnosis; after therapy, 63% (15/24) had none, 33% (8/24) had < 3 x 10(6)/L, and only one had > or = 3 x 10(6)/L. In nine cases who failed to respond to initial chemotherapy, 89% (8/9) had high levels (> or = 3 x 10(6)/L) of circulating PC at diagnosis that remained high after therapy. In the relapse phase, 88% (21/24) had circulating PC and 63% (15/24) had high numbers. This study demonstrates that the PB is least likely to have circulating monoclonal PC during the period after successful chemotherapy. Patients who fail to respond to initial chemotherapy or are in relapse are likely to have tumor cells in the PB.

References

Jun 1, 1989·British Journal of Haematology·A BaggB Mendelow
May 1, 1989·British Journal of Haematology·E K ChiuA B Mehta
Jun 1, 1988·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·T E WitzigP R Greipp
Apr 1, 1988·European Journal of Haematology·M BoccadoroA Pileri

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Citations

Mar 29, 2003·Journal of Hematotherapy & Stem Cell Research·K RemesA Rajamäki
Jun 28, 2001·Leukemia & Lymphoma·L F LinczA Spencer
Jun 10, 2006·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Jesús F San MiguelAlberto Orfao
Sep 16, 2008·Best Practice & Research. Clinical Haematology·Jacalyn Rosenblatt, David Avigan
Dec 12, 2007·Best Practice & Research. Clinical Haematology·Hervé Avet-Loiseau

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