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Myelomonocytic antigen positive multiple myeloma
TM Grogan, BG Durie, CM Spier, L Richter and E Vela
Department of Pathology, Arizona Cancer Center, University of Arizona,
Tucson 85724.
In a four year span, between 1983 and 1987, 215 bone marrow and cell
culture samples from 125 myeloma patients were immunotyped and coexpression
of myelomonocytic and plasma cell antigens occurred in 16 (13%). We
employed both immunohistochemical and flow cytometry methods including
coplots and double labelling. Three types of myeloma cases were found: (1)
those with isolated myeloid antigen coexpression, usually Leu M1 or
esterase (BE, CE) positive (11 cases); (2) those with multiple myeloid
antigens (Leu M1, M3, M5, MY7, BE, CE) (four cases); and (3) one case
beginning as 1 and ending as 2. Isolated myeloid antigen expression was
generally associated with typical features of myeloma with survival close
to the anticipated median (33 months), while multiple myeloid antigen
expression was associated with more aggressive disease and shorter survival
duration (median survival 16 months). The latter subgroup also had other
poor prognostic factors including high labelling index and common acute
lymphoblastic leukemia antigen (CALLA) positivity. Other features found
overall were frequent abnormal karyotypes (seven of 12 abnormal) and
coexpressed IgA (eight of 16); all IgA+ cases also coexpressed Leu M1. We
conclude that there is an unusual and unexpected predilection for
coexpression of myelomonocytic antigens in myeloma cells. The reasons are
not immediately obvious. Whether the coexpression indicates that myeloma
cells truly have latent multilineage potential or just aberrantly coexpress
other hematopoietic antigens as a manifestation of malignancy remains to be
explained. However, a cell line established from the bone marrow of one
patient is a valuable scientific tool allowing detailed analysis of these
questions.
Volume 73,
Issue 3,
pp. 763-769,
02/15/1989
Copyright © 1989 by The American Society of Hematology
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