[The clonal origin of multiple myeloma].
In order to explore the clonal origin and malignant pathway of multiple myeloma (MM), a study has been made to investigate the differentiation stage of malignant progenitor cells in peripheral blood (PB) of MM. The immnophenotype of mononuclear cells (MC) in PB and bone marrow (BM) from 17 patients with MM were studied with APAAP method by using monoclonal antibodies directed to a series of B-cell markers (CD10, CD19, CD20, CD45RA, CD45RO, CD38). There were no plasma cells in samples of PB examined. Out of the 17 patients, MC of PB from 10 expressed plasma cell antigen CD38. This expression was significantly different from normal control (P < 0.001) and identical with that of BM. MC of 9 patients were CD38+ and CD45RO+, 3 were CD38+, CD45RO+ and CD45RA+ and 1 was CD38+, CD45RA+, CD45RO+ and CD10+ in PB. The results indicate that while the B-cell marker's expression of PB matches with that of BM, its forms are diversified. This suggests that the PB of MM patients contains precursors at multiple differentiation stages of myeloma cells, from early B cell to active B cell, late B cell and preplasma cell. MC of PB from 10 patients expressed CD45RO while that of BM from 5 out of them expressed the same. This indicates that preplasma cells which are CD45RO+ in PB may eventually return to BM for homing and differentiating into plasma cells, thus losing CD45RO and expressing CD38 only. This study has proved the presence of malignant cells in PB of MM, confirmed the speculation of the malignant pattern and provided the theoretical basis for purging of PB in autologous peripheral blood stem cell transplantation.
Wang
Y
Y
First Hospital of Beijing Medical University.
Wu
S
S
Xue
H
H
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000097:blood; D018941:Antigens, CD19 / Q000097:blood; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D017493:Leukocyte Common Antigens / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology / Q000276:immunology*
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D018941:Antigens, CD19; D017493:Leukocyte Common Antigens