Serial studies of peripheral blood myeloma cells in patients with multiple myeloma: When is the optimal time for stem cell harvest?

Thomas E. Witzig, Morie A. Gertz, John A. Lust, Robert A. Kyle, Philip R. Greipp

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

This study serially quantitated monoclonal plasma cells (PC) in the peripheral blood (PB) of 33 patients with multiple myeloma (MM) at diagnosis, after therapy, and at relapse using a sensitive immunofluorescence technique. The goal was to learn which disease phase is best for harvesting PB stem cells free of monoclonal PC. In 24 chemotherapy responders, 88% (21/24) had circulating PC at diagnosis; after therapy, 63% (15/24) had none, 33% (8/24) had <3 × 106/L, and only one had ≥3 × 106/L. In nine cases who failed to respond to initial chemotherapy, 89% (8/9) had high levels (≥3 × 106/L) of circulating PC at diagnosis that remained high after therapy. In the relapse phase, 88% (21/24) had circulating PC and 63% (15/24) had high numbers. This study demonstrates that the PB is least likely to have circulating monoclonal PC during the period after successful chemotherapy. Patients who fail to respond to initial chemotherapy or are in relapse are likely to have tumor cells in the PB.

Original languageEnglish (US)
Pages (from-to)417-422
Number of pages6
JournalLeukemia and Lymphoma
Volume19
Issue number5-6
DOIs
StatePublished - Jan 1 1995

Keywords

  • Bone marrow transplant
  • Multiple myeloma
  • Stem cells

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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