Cooper D A, Miller A C, Penny R
Acta Haematol. 1982;68(3):224-36. doi: 10.1159/000206985.
Tumour cell mass (TCM) in patients with multiple myeloma has been measured by synthetic rate studies of bone-marrow tumor cells in culture. From the measurements of Salmon and co-workers, a simple clinical staging system in which TCM is calculated by a programmable pocket calculator has been developed. We have compared the measurement and calculation of TCM in patients with IgG and IgA multiple myeloma by these methods in our own laboratory. There was correlation between synthetic rate and serum IgG paraprotein concentration but not the serum IgA paraprotein concentration. In patients with IgG myeloma there was correlation between measured and calculated TCM as well as measured TCM and serum IgG paraprotein concentration, urine Bence-Jones protein excretion, and serum albumin concentration. Measured TCM also inversely correlated with haemoglobin concentration. In patients with IgA myeloma, however, there was no correlation between measured TCM and calculated TCM or any other individual clinical laboratory parameter. A number of problems have contributed to the overall failure of this method to measure and calculate TCM including methodological differences, definition of myeloma cells, proteolysis of newly synthesized paraprotein in culture, changes in synthetic rates with time and assessment of the degree of bone lesions by skeletal roentgenograms. We cannot recommend these methods as they stand to measure and calculate TCM in patients with multiple myeloma.
通过对培养的骨髓肿瘤细胞进行合成速率研究，已对多发性骨髓瘤患者的肿瘤细胞团（TCM）进行了测量。根据萨尔蒙及其同事的测量结果，开发了一种简单的临床分期系统，其中TCM可通过可编程袖珍计算器进行计算。我们在自己的实验室中，通过这些方法比较了IgG和IgA多发性骨髓瘤患者TCM的测量和计算结果。合成速率与血清IgG副蛋白浓度之间存在相关性，但与血清IgA副蛋白浓度无关。在IgG骨髓瘤患者中，测量的TCM与计算的TCM之间、测量的TCM与血清IgG副蛋白浓度、尿本-周蛋白排泄量以及血清白蛋白浓度之间均存在相关性。测量的TCM也与血红蛋白浓度呈负相关。然而，在IgA骨髓瘤患者中，测量的TCM与计算的TCM或任何其他个体临床实验室参数之间均无相关性。该方法在测量和计算TCM方面总体失败，存在许多问题，包括方法学差异、骨髓瘤细胞的定义、培养中新合成副蛋白的蛋白水解、合成速率随时间的变化以及通过骨骼X线片评估骨病变程度等。就目前而言，我们不推荐这些方法用于测量和计算多发性骨髓瘤患者的TCM。
