Paul Chandramallika, Chakraborty Sarit, Chakraborty Subhosmito
Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, 741245 India.
Department of CSE, Government College of Engineering and Leather Technology, Kolkata, West Bengal 700106 India.
Indian J Clin Biochem. 2022 Jul;37(3):328-334. doi: 10.1007/s12291-021-00983-0. Epub 2021 May 19.
Multiple myeloma (MM) is a rare malignant condition with an abnormal clonal proliferation of plasma cells in the bone marrow. Chemotherapy and Hematopoietic Stem cell transplantation (HCT) are the main modalities of myeloablative therapy. The study aimed to determine the frequency of oligoclonal bands (OB) in multiple myeloma patients receiving primary therapy alone with chemotherapy as well as patients undergoing HCT at a single institution. The clinical and laboratory records of 76 MM patients were reviewed who underwent HCT from January 2012 to January 2019. Another 74 cases receiving chemotherapy alone, were also reviewed. In total 85 patients were selected by the availability of at least 3 serial immunofixation electrophoresis(IFE) results in non-transplanted cases and 2 post-transplant IFE results in the HCT cases after attainment of very good partial response(VGPR). 40 patients were non transplanted cases while 45 patients underwent HCT. Oligoclonal bands emerged in twenty-four (28%) patients 15% (6/40) of the patients treated without HCT and, 40% (18/45) of patients treated with HCT from their respective cohorts. To conclude, this is the first Indian report showing a higher frequency of oligoclonal response in patients in VGPR attained after hematopoietic stem cell transplantation versus chemotherapy. This difference could be due to a stronger immune reconstitution, or graft vs. host reaction, or autoimmune response to myeloma antigens and may not be an active disease process or relapse. However to determine the prognostic impact of OB further investigations and follow-ups are required.
多发性骨髓瘤（MM）是一种罕见的恶性疾病，其特征为骨髓中浆细胞异常克隆增殖。化疗和造血干细胞移植（HCT）是清髓性治疗的主要方式。本研究旨在确定在单一机构接受单纯化疗初始治疗的多发性骨髓瘤患者以及接受HCT患者中寡克隆带（OB）的出现频率。回顾了2012年1月至2019年1月期间接受HCT的76例MM患者的临床和实验室记录。另外还回顾了74例仅接受化疗的病例。根据非移植病例中至少3次连续免疫固定电泳（IFE）结果以及HCT病例达到非常好的部分缓解（VGPR）后2次移植后IFE结果，共选择了85例患者。40例为非移植病例，45例接受了HCT。在各自队列中，24例（28%）患者出现了寡克隆带，其中未接受HCT治疗的患者中有15%（6/40）出现，接受HCT治疗的患者中有40%（18/45）出现。总之，这是印度的首份报告，显示造血干细胞移植后达到VGPR的患者中寡克隆反应的频率高于化疗患者。这种差异可能是由于更强的免疫重建、移植物抗宿主反应或对骨髓瘤抗原的自身免疫反应，可能并非活跃的疾病进程或复发。然而，要确定OB的预后影响，还需要进一步的研究和随访。
