Monitoring of plasma cell proliferative and apoptotic indices in the course of multiple myeloma.
In a group of 310 patients with multiple myeloma (MM) we assessed the proliferative (PC-PI) and apoptotic indices (PC-AI). Patients were divided according to the disease state, i.e. at the time of diagnosis, in relapse, and in MM remission. We assessed the behavior of both indices with respect to therapy response and activity of the disease. In patients who reached remission, there was a significant decrease of PC-PI together with an increase of PC-AI in comparison with initial measurements. In non-responders, there was a reverse trend with increasing PC-PI and decreasing PC-AI. The values of PC-PI and PC-AI in residual myeloma population were similar regardless of treatment, i.e. in patients treated using conventional chemotherapy and after high-dosed chemotherapy with autologous stem cell transplant. Patients in long-lasting remission phase maintained stable low values of PC-PI with high PC-AI without a significant change, whereas in the group of progressing/relapsing patients, there was a significant increase of PC-PI together with a decrease of PC-AI. Our results suggest that longitudinal measurement of proliferative and apoptotic indices in MM plasmocytes helps to estimate the behavior of the tumor population and may thus become a convenient auxiliary parameter for prognosis and a targeted, individualized treatment approach.
Minarik
Jiri
J
Department of Internal Medicine III, University Hospital Olomouc, Czech Republic. abretina@email.cz
Scudla
Vlastimil
V
Ordeltova
Marta
M
Bacovsky
Jaroslav
J
Pika
Tomas
T
Langova
Katerina
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017209:Apoptosis; D049109:Cell Proliferation; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009101:Multiple Myeloma / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010950:Plasma Cells / Q000473:pathology*; D011379:Prognosis; D033581:Stem Cell Transplantation / Q000379:methods; D014182:Transplantation, Autologous