Varghese Abraham M, Rawstron Andy C, Ashcroft A John, Moreton Paul, Owen Roger G
HMDS Laboratory, St James's Institute of Oncology, Leeds, UK.
Clin Lymphoma Myeloma. 2009 Mar;9(1):53-5. doi: 10.3816/CLM.2009.n.013.
In this study we used bone marrow flow cytometry and immunohistochemistry to evaluate response to fludarabine therapy in patients with Waldenström's macroglobulinemia (WM)/lymphoplasmacytic lymphoma. Responses in serum M protein were typically delayed with a median time to maximum response of 6 months following the completion of therapy (range, 0-18 months). In contrast, bone marrow responses occurred promptly in responding patients such that there were no detectable clonal B cells at the end of therapy in 55% of patients assessed. Persistent monoclonal plasma cells were, however, readily identified by CD138 immunohistochemistry, explaining the persistence of serum M protein in these patients. This simple observation has significant implications for the assessment of responses in WM as well as the design of future therapeutic strategies.
在本研究中，我们使用骨髓流式细胞术和免疫组织化学来评估氟达拉滨治疗华氏巨球蛋白血症（WM）/淋巴浆细胞淋巴瘤患者的疗效。血清M蛋白的反应通常延迟，治疗完成后达到最大反应的中位时间为6个月（范围为0 - 18个月）。相比之下，有反应的患者骨髓反应迅速，以至于在评估的患者中，55%在治疗结束时未检测到克隆性B细胞。然而，通过CD138免疫组织化学很容易识别出持续存在的单克隆浆细胞，这解释了这些患者血清M蛋白持续存在的原因。这一简单的观察结果对WM反应的评估以及未来治疗策略的设计具有重要意义。
