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Myeloma

The detection of contaminating clonal cells in apheresis products is related to response and outcome in multiple myeloma undergoing autologous peripheral blood stem cell transplantation

Leukemia volume 14, pages 1493–1499 (2000)Cite this article

Abstract

In the present paper, we report on the use of the heteroduplex PCR technique to detect the presence of clonally rearranged VDJ segments of the heavy chain immunoglobulin gene (VDJH) in the apheresis products of patients with multiple myeloma (MM) undergoing autologous peripheral blood stem cell (APBSC) transplantation. Twenty-three out of 31 MM patients undergoing APBSC transplantation with VDJH segments clonally rearranged detected at diagnosis were included in the study. Samples of the apheresis products were PCR amplified using JHand VH (FRIII and FRII) consensus primers and subsequently analyzed with the heteroduplex technique, and compared with those obtained at diagnosis. 52% of cases yielded positive results (presence of clonally rearranged VDJH segments in at least one apheresis). The presence of positive results in the apheresis products was not related to any pre-transplant characteristics with the exception of response status at transplant. Thus, while no one patient with positive apheresis products was in complete remission (CR), negative immunofixation, before the transplant, five cases (46%) with negative apheresis were already in CR at transplant (P = 0.01). The remaining six cases with heteroduplex PCR negative apheresis were in partial remission before transplant. Patients with clonally free products were more likely to obtain CR following transplant (64% vs 17%, P = 0.02) and a longer progression-free survival, (40 months in patients transplanted with polyclonal products vs 20 with monoclonal ones, P = 0.03). These results were consistent when the overall survival was considered, since it was better in those patients with negative apheresis than it was in those with positive (83% vs36% at 5 years from diagnosis, P = 0.01). These findings indicate that the presence of clonality rearranged VDJH segments is related to the response and outcome in MM transplanted patients.

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Acknowledgements

The authors thank Mark Anderson and Felicitación García for their technical assistance. This work has been partially supported with grant number 99/1243 from the Spanish Fondo de Investigaciones Sanitarias and grant 1997 from the Areces Foundation. MVM was supported with a grant from the LAIR Foundation.

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  1. Servicio de Hematología, Hospital Universitario de Salamanca, Centro de Investigación del Cáncer (CIC), Universidad de Salamanca, Spain

    R López-Pérez, R García-Sanz, D González, A Balanzategui, MC Chillón, I Alaejos, MV Mateos, MD Caballero, G Mateo, MJ Nieto, M González & JF San Miguel

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López-Pérez, R., García-Sanz, R., González, D. et al. The detection of contaminating clonal cells in apheresis products is related to response and outcome in multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Leukemia 14, 1493–1499 (2000). https://doi.org/10.1038/sj.leu.2401862

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