Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Significance of Oligoclonal Bands after Stem Cell Transplantation in Multiple Myeloma Cases

  • Liu, Ai-Jun (Department of Hematology, Chao Yang Hospital, Capital Medical University) ;
  • Zong, Hong (Department of Clinical Laboratory, Chao Yang Hospital, Capital Medical University) ;
  • Yang, Guang-Zhong (Department of Hematology, Chao Yang Hospital, Capital Medical University) ;
  • Zhai, Yu-Hua (Department of Clinical Laboratory, Chao Yang Hospital, Capital Medical University) ;
  • Li, Li-Hong (Department of Hematology, Chao Yang Hospital, Capital Medical University)
  • Published : 2012.04.30
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Abstract

Objective: To determine the characteristics of oligoclonal bands that are frequently detected by serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE) after stem cell transplantation. Methods: We retrospectively analyzed 56 patients with multiple myeloma (MM) undergoing transplantation, and standard immunofixation electrophoresis was used to identify and quantify paraproteins. Results: The median follow-up was 35 months (range, 10-76months) and 21 patients relapsed. Twelve (25.0%) demonstrated oligoclonal bands after a median time 1.4 months (range, 1-3months), with a median duration of 5.8 months (range, 1-15months). The majority patients with oligoclonal bands had normal quantities of immunoglobulins and the one year event free survival (EFS) was 92%, even higher than for patients without OBs (P=0.002). Conclusion: Oligoclonal bands frequent develop post-transplantation in MM cases. In the vast majority of patients, they may not represent relapsed disease, and more likely represent a transient phenomenon representing recovery of impaired immunoglobulin production.

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References

  1. Bergsagel PL, Chesi M, Nardini E, et al (1996). Promiscuous translocations into immunoglobulin heavy chain switch regions in multiple myeloma. Proc Nat Acad Sci USA, 93, 13931-6. https://doi.org/10.1073/pnas.93.24.13931
  2. Blade J, Samson D, Reece D, et al (1998). Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol, 102, 1115-23. https://doi.org/10.1046/j.1365-2141.1998.00930.x
  3. De Larrea CF, Cibeira MT, Elena M, et al (2009). Abnormal serum free-light chain ratio in patients with multiple myeloma in long-lasting complete remission, strong association with oligoclonal bands. Haematologica, 94, 375.
  4. Gerritsen EJA, Vantol MJD, Lankester AC, et al (1993). Immunoglobulin levels and monoclonal, gammopathies in children after bone marrow transplantation. Blood, 82, 3493-502.
  5. Gerritsen EJA, Van tol MJD, Van't veer MB, et al (1994). Clonal dysregulation of the antibody response to tetanustoxoid after bone marrow transplantation. Blood, 84, 4374-82.
  6. Guikema JE, Vellenga E, Veeneman JM, et al (1999). Multiple myeloma related cells in patients undergoing autologous peripheral blood stem cell transplantation. Br J Haematol, 104, 748-54. https://doi.org/10.1046/j.1365-2141.1999.01233.x
  7. Hari PN, Zhang MJ, Roy V, et al (2009). Is the international staging system superior to the Durie-Salmon staging system? 10, 1038.
  8. Hovenga S, de Wolf JT, Guikema JE, et al (2000). Autologous stem cell transplantation in multiple myeloma after VAD and EDAP courses, a high incidence of oligoclonal serum Igs post transplantation. Bone Marrow Transplant, 25, 723-8. https://doi.org/10.1038/sj.bmt.1702194
  9. Kyle RA, Robinson RA, Katzmann JA (1981). The clinical aspects of biclonal gammopathies. Review of 57 cases. Am J Med, 71, 999-1008. https://doi.org/10.1016/0002-9343(81)90326-0
  10. Maisnar V, Tichý M, Smolej L, et al (2007). Isotype class switching after transplantation in multiple myeloma. Neoplasma, 54, 225-8.
  11. Mariel EA, Leticia BM, Miguel AP, et al (2010). Oligoclonal bands and immunoglobulin isotype switch during monitoring of patients with multiple myeloma and autologous hematopoietic cell transplantation, a 16-year experience. Clin Chem Lab Med, 48, 727-31.
  12. Mitus AJ, Stein R, Rappenport JM, et al (1989). Monoclonal and oligoclonal gammoppathy after bone marrow transplantation. Blood, 74, 2764-8.
  13. Sara L. H, Jill T, Devinder G, et al (2009). Significance of abnormal protein bands in patients with multiple myeloma following autologous stem cell transplantation. Clin Biochem Rev, 30, 113-8.
  14. Small TN, Keever CA, Weiner-fedus S, et al (1990). B-cell differentiation following autologous, conventional or T-cell depleted bone marrow transplantation, A recapitulation of normal B cell ontogeny. Blood, 76, 1647-56.
  15. Tormey WP (1998). Low concentration monoclonal and oligoclonal bands in serum and urine using the Sebia Hydragel Protein Electrophoresis System. Clin Chem Lab Med, 36, 253-4.
  16. Velardi A, Cucciaioni S, Terenzi A, et al (1988). Acquisition of Ag isotype diversity after bone marrow transplantation in adults, A recapitulation of normal B cell ontogeny. J Immunol, 141, 815-20.
  17. Vesole D, Vanier A, Flick J, et al (1992). Monoclonal immunoglobulin isotype switches in multiple myeloma patients following high high dose chemotherapy. Blood, 80, 122a.
  18. Zent CS, Wilson CS, Tricot G, et al (1998). Oligoclonal protein bands and Ig isotype switching in multiple myeloma treated with high-dose therapy and hematopoietic cell transplantation. Blood, 91, 3518-23.

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