Kallmeyer C, Wallmeier M, Kiel K, Moos M, Hegenbart U, Haas R, Goldschmidt H
Department of Internal Medicine V, University of Heidelberg, Germany.
Am J Hematol. 1998 Apr;57(4):287-92. doi: 10.1002/(sici)1096-8652(199804)57:4<287::aid-ajh4>3.0.co;2-q.
Reports of high numbers of circulating monotypic B cells in patients with multiple myeloma (MM) have recently been published. These cells, which were identified by their expression of CD19, were reported to be resistant to conventional chemotherapy and to represent the source of relapse. We examined blood samples from 48 patients before and 53 patients after glucocorticoid containing chemotherapy by dual color flow cytometry. The absolute count of CD19+B cells in patients before treatment (212.6+/-24.8 x 10(6)/l) was decreased compared to normal controls (P = .038). In the post-treatment group, circulating B cells were highly significantly lower than in untreated patients (45.23+/-6.69 x 10(6)/l. P < .001). This reduction was also seen in 26 patients, that were followed during chemotherapy. The cytoplasmic kappa/lambda ratio was within normal range before and after treatment with no difference according to the light chain isotype of the paraprotein. We conclude that circulating B cells are not increased in patients with MM, that the majority of these cells are polyclonal, and that conventional chemotherapy effectively reduces circulating B cells without leading to dominance of resistant monotypic cells.
近期有关于多发性骨髓瘤（MM）患者循环单型B细胞数量增多的报道发表。这些通过表达CD19鉴定的细胞据报道对传统化疗耐药，并代表复发的根源。我们采用双色流式细胞术检测了48例患者化疗前及53例含糖皮质激素化疗后的血样。治疗前患者CD19+B细胞的绝对计数（212.6±24.8×10⁶/L）与正常对照相比降低（P = 0.038）。在治疗后组，循环B细胞显著低于未治疗患者（45.23±6.69×10⁶/L，P < 0.001）。在化疗期间随访的26例患者中也观察到这种减少。治疗前后细胞质κ/λ比值在正常范围内，根据副蛋白的轻链同种型无差异。我们得出结论，MM患者循环B细胞并未增多，这些细胞大多数是多克隆的，并且传统化疗可有效减少循环B细胞，而不会导致耐药单型细胞占优势。
