In Non-transplant Patients with Multiple Myeloma, the Pre-treatment Level of Clonotypic Cells Predicts Event-free Survival

Overview

Journal Mol Cancer

Publisher Biomed Central

Specialties Molecular Biology
Oncology

Date 2012 Oct 23

PMID 23083101

Citations 2

Authors

Kyle J Thulien

Andrew R Belch

Tony Reiman

Linda M Pilarski

Affiliations

Soon will be listed here.

Abstract

Background: In multiple myeloma (MM), the immunoglobulin heavy chain VDJ gene rearrangement is a unique clonotypic signature that identifies all members of the myeloma clone independent of morphology or phenotype. Each clonotypic MM cell has only one genomic copy of the rearranged IgH VDJ.

Methods: Pre-treatment bone marrow aspirates from myeloma patients at diagnosis or in relapse were evaluated for the number of clonotypic cells using real time quantitative PCR (RPCR). RPCR measured the level of clonal cells, termed VDJ%, in 139 diagnosis and relapse BM aspirates from MM patients.

Results: Patients with a VDJ% below the median had a significantly longer event free survival (EFS) then those with a VDJ% higher than the median (p=0.0077, HR=0.57). Further, although the VDJ% from non-transplant patients predicted EFS (p=0.0093), VDJ% failed to predict outcome after autologous stem cell transplant (p=0.53).

Conclusions: Our results suggest that for non-transplant patients, the tumor burden before treatment, perhaps reflecting cancer stem cell progeny/output, is an indirect measure that may indicate the number of MM cancer stem cells and hence event free survival.

Citing Articles

The evolution of malignant and reactive γδ + T cell clones in a relapse T-ALL case after allogeneic stem cell transplantation.

Chen S, Huang X, Zheng H, Geng S, Wu X, Yang L Mol Cancer. 2013; 12:73.

PMID: 23849082 PMC: 3717050. DOI: 10.1186/1476-4598-12-73.

Frequent occurrence of highly expanded but unrelated B-cell clones in patients with multiple myeloma.

Kriangkum J, Motz S, Debes Marun C, Lafarge S, Gibson S, Venner C PLoS One. 2013; 8(5):e64927.

PMID: 23724106 PMC: 3665682. DOI: 10.1371/journal.pone.0064927.

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