Shiratori Souichi, Kondo Takeshi, Kubota Kanako, Wakasa Kentarou, Ibata Makoto, Shono Yusuke, Takahata Mutsumi, Shigematu Akio, Kato Naoko, Ota Shuichi, Tanaka Junji, Matsuno Yoshihiro, Asaka Masahiro, Imamura Masahiro
Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine.
Rinsho Ketsueki. 2008 Nov;49(11):1536-40.
Several studies have confirmed that CD20 is expressed in about 20% of multiple myeloma (MM) cases. This is closely related to a chromosomal translocation between chromosome 11 and chromosome 14, which results in the expression of CyclinD1. The use of rituximab (RIT) in the treatment of CD20-positive MM has been reported, however its effectiveness is still not well established. We encountered a case of CD20-positive/CyclinD1-positive MM; interestingly, CD20 expression could not be detected in MM cells following RIT-combined chemotherapy, while it gradually recovered when RIT therapy was discontinued. This is the first report in which the transition of CD20 expression was accurately analyzed by flow cytometry and immunohistochemical staining before, during and after RIT treatment. Consequently, this case provides insight regarding the mechanism through which CD20 expression is lost following RIT therapy for CD20-positive lymphoid neoplasm, as well as the efficacy of RIT in CD20-positive MM.
多项研究证实,约20%的多发性骨髓瘤(MM)病例中表达CD20。这与11号染色体和14号染色体之间的染色体易位密切相关,该易位导致细胞周期蛋白D1的表达。已有报道使用利妥昔单抗(RIT)治疗CD20阳性MM,但其有效性仍未完全确立。我们遇到一例CD20阳性/细胞周期蛋白D1阳性MM;有趣的是,RIT联合化疗后MM细胞中未检测到CD20表达,但停用RIT治疗后其表达逐渐恢复。这是第一份通过流式细胞术和免疫组织化学染色在RIT治疗前、治疗期间和治疗后准确分析CD20表达转变的报告。因此,该病例为RIT治疗CD20阳性淋巴瘤后CD20表达缺失的机制以及RIT在CD20阳性MM中的疗效提供了见解。