Immunophenotypic and genotypic characterisation of multiple myelomas with adverse prognosis characterised by immunohistological expression of the T cell related antigen CD45RO (UCHL-1).
OBJECTIVE
To investigate whether plasma cell expression of early B cell, late B cell/preplasma cell, T cell, and myelomonocytic antigens or myeloma associated lymphocytic infiltrates correlated with prognosis in bone marrow biopsy specimens of patients with multiple myeloma.


METHODS
Bone marrow biopsy specimens of 23 patients with multiple myeloma were investigated for plasma cell expression and interstitial lymphocyte expression of T cell related antigen CD45RO (UCHL-1).


RESULTS
Eight patients showed plasma cell expression of CD45RO and 16 showed increased tumour infiltrating CD45RO positive lymphocytes, which were correlated with poor survival by multivariate analyses (p = 0.005 and p = 0.04, respectively). B cell antigens (MB2, CD20) but no T cell specific antigens (CD3) or T cell receptor gene rearrangements were expressed by plasma cells in CD45RO positive myelomas. Of 16 patients with myeloma who had increased tumour infiltrating CD45RO positive lymphocytes, four had interstitial lymphocyte expression of B cell antigens and two had interstitial lymphocyte expression of the T cell specific antigen CD3.


CONCLUSIONS
The recognition of plasma cell expression of CD45RO and increased interstitial CD45RO lymphocytes in bone marrow biopsy specimens of patients with multiple myeloma is an adverse prognostic finding not indicative of an aberrant T cell phenotype or genotype; it is consistent with B cell/pre-plasma cell antigen expression by myeloma cells and their lymphocytic precursors.
Department of Pathology, Mayo Clinic Jacksonville, Florida, USA.
D M
DM
Menke
H P
HP
Horny
H
H
Griesser
E J
EJ
Atkinson
E
E
Kaiserling
R A
RA
Kyle
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001854:Bone Marrow Cells / Q000276:immunology*; D017252:CD3 Complex / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D000949:Histocompatibility Antigens Class II / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D017493:Leukocyte Common Antigens / Q000032:analysis*; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology* / Q000401:mortality; D010950:Plasma Cells / Q000276:immunology; D010954:Plasmacytoma / Q000276:immunology; D011379:Prognosis; D012044:Regression Analysis; D015996:Survival Rate
D018951:Antigens, CD20; D015415:Biomarkers; D017252:CD3 Complex; D000949:Histocompatibility Antigens Class II; D017493:Leukocyte Common Antigens