Vescio R A, Han E J, Schiller G J, Lee J C, Wu C H, Cao J, Shin J, Kim A, Lichtenstein A K, Berenson J R
Division of Hematology/Oncology, DVA West Los Angeles, CA 90073, USA.
Bone Marrow Transplant. 1996 Jul;18(1):103-10.
Autologous transplantation is increasingly being used to treat patients with multiple myeloma (MM). Recently, peripheral blood progenitor cell (PBPC) harvest have been preferred over autologous bone marrow (BM) harvests due to reduced engraftment time, ease of attainment, and presumptive reduction of occult tumor involvement. To resolve this latter assumption quantitatively, we have used the unique immunoglobulin (Ig) heavy chain variable region sequence of the patient's myeloma cell as a marker of clonality. Samples from PBPC collections and 'back-up' BM harvests were obtained from 13 patients with MM and analyzed for tumor contamination using patient-specific oligonucleotide primers and the polymerase chain reaction. As expected, the percentage of tumor cells contaminating the BM harvest (median, 0.74%) was higher than in the PBPC specimens (median, 0.0024%). Because of the increased total number of cells required for PBPC transplantation, the increase in total number of contaminating cells in the BM vs PBPC autografts was less pronounced, (BM:PBPC tumor contamination ratios ranging from 0.9 to > 4500; median, 14). This confirms that in most but not all cases unmanipulated PBPC products are preferable over BM harvests as a method of reducing myeloma autograft tumor contamination.
自体移植越来越多地用于治疗多发性骨髓瘤（MM）患者。近来，由于植入时间缩短、获取容易以及推测可减少隐匿性肿瘤累及，外周血祖细胞（PBPC）采集已比自体骨髓（BM）采集更受青睐。为了定量解决后一种假设，我们使用患者骨髓瘤细胞独特的免疫球蛋白（Ig）重链可变区序列作为克隆性的标志物。从13例MM患者获取PBPC采集样本和“备用”BM采集样本，并使用患者特异性寡核苷酸引物和聚合酶链反应分析肿瘤污染情况。正如预期的那样，污染BM采集样本的肿瘤细胞百分比（中位数为0.74%）高于PBPC样本（中位数为0.0024%）。由于PBPC移植所需的细胞总数增加，BM与PBPC自体移植物中污染细胞总数的增加不太明显（BM:PBPC肿瘤污染率范围为0.9至>4500；中位数为14）。这证实，在大多数但并非所有情况下，作为减少骨髓瘤自体移植肿瘤污染的一种方法，未处理的PBPC产物比BM采集更可取。
