Dreyfus F, Ribrag V, Leblond V, Ravaud P, Melle J, Quarre M C, Pillier C, Boccaccio C, Varet B
Department of Haematology and Blood Bank, Hôpital Cochin, Paris.
Bone Marrow Transplant. 1995 May;15(5):707-11.
Autologous transplantation after high-dose chemo or radiotherapy is now frequently used for the treatment of patients with multiple myeloma (MM). The collection of peripheral blood stem cells (PBSC) has a theoretical advantage over autologous bone marrow collection as the malignant plasmacytic contamination is believed to be lower. However, the extent of B cell contamination in PBSC has not been extensively investigated. Using an immunoglobulin heavy chain gene 'fingerprinting' technique at diagnosis and during apheresis after one cycle of chemotherapy we detected a monoclonal population in 44% of PBSC samples (9 positives in 22 studied). There was no correlation between contamination and sex, age, Durie and Salmon classification, C-reactive protein and albumin. A significant correlation was observed with beta 2 microglobulin serum level (P = 0.02). Twenty one patients were grafted and up to the present, with a mean follow-up of 12 months, 6 patients have relapsed including 4 patients with contaminating B cells. Our results suggest that PBSC contamination, defines a 'poor risk' group of patients, with poor prognosis. However, we could not exclude reinitiation of the disease by plasmacyte stem cells after grafting.
高剂量化疗或放疗后的自体移植目前常用于治疗多发性骨髓瘤（MM）患者。外周血干细胞（PBSC）采集相对于自体骨髓采集具有理论优势，因为据信恶性浆细胞污染较低。然而，PBSC中B细胞污染的程度尚未得到广泛研究。在诊断时以及化疗一个周期后的单采过程中，使用免疫球蛋白重链基因“指纹识别”技术，我们在44%的PBSC样本中检测到单克隆群体（22个研究样本中有9个阳性）。污染与性别、年龄、Durie和Salmon分期、C反应蛋白及白蛋白之间无相关性。观察到与β2微球蛋白血清水平存在显著相关性（P = 0.02）。21例患者接受了移植，截至目前，平均随访12个月，6例患者复发，其中4例患者的B细胞存在污染。我们的结果表明，PBSC污染定义了一组“高危”患者，预后较差。然而，我们不能排除移植后浆细胞干细胞引发疾病复发的可能性。
