Melphalan-mobilized blood stem cell components contain minimal clonotypic myeloma cell contamination Journal Article

Authors: Zhou, P.; Zhang, Y.; Martinez, C.; Kalakonda, N.; Nimer, S. D.; Comenzo, R. L.
Article Title: Melphalan-mobilized blood stem cell components contain minimal clonotypic myeloma cell contamination
Abstract: Optimal methods of stem cell mobilization in multiple myeloma are undefined, and contaminating clonotypic cells could contribute to disease recurrence. A phase 2 trial of intravenous melphalan (60 mg/m2) and granulocyte colony-stimulating factor (G-CSF) (10 μg/kg/d) for mobilization was performed. To enhance reliability, contamination was assessed with 2 sensitive methods, immunoglobulin light and heavy chain variable region patient-specific limiting-dilution polymerase chain reaction (PCR). We evaluated 29 stem cell components (SCCs) from 15 patients; for 9 SCCs, only VL PCR was used because of light chain disease or technical problems with VH primers. For 20 SCCs, VL and VH PCR results were highly correlated (r2 = 0.93, P < .01), with 35% (7 of 20) having identical estimates. VH PCR gave significantly higher estimates for 8 - and VL PCR for 5 - SCCs, supporting the utility of using 2 methods. Estimated clonotypic contamination per SCC was 0.0009% (range, 0%-0.1%) or 0.5 × 104 clonotypic cells per kilogram (range, 0-41.2 x 104/kg), and contamination correlated with CD34+ cells collected (r2 = 0.42, P < .01). Melphalan-mobilized SCCs contain minimal clonotypic contamination. © 2003 by The American Society of Hematology.
Keywords: adult; clinical article; controlled study; aged; middle aged; human cell; clinical trial; sensitivity and specificity; polymerase chain reaction; cell function; controlled clinical trial; multiple myeloma; phase 2 clinical trial; melphalan; immunoglobulin g; stem cell mobilization; recurrent disease; intermethod comparison; reliability; immunoglobulin light chain; granulocyte colony stimulating factor; granulocyte colony-stimulating factor; hematopoietic stem cell mobilization; clone cells; immunoglobulin a; leukapheresis; somatic hypermutation, immunoglobulin; myeloma cell; neoplasm circulating cells; myeloma proteins; gene rearrangement, b-lymphocyte, heavy chain; humans; human; male; female; priority journal; article; gene rearrangement, b-lymphocyte, light chain
Journal Title: Blood
Volume: 102
Issue: 2
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2003-07-15
Start Page: 477
End Page: 479
Language: English
DOI: 10.1182/blood-2002-12-3674
PUBMED: 12649134
PROVIDER: scopus
Notes: Export Date: 12 September 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. Yana Zhang
    12 Zhang
  2. Raymond L Comenzo
    114 Comenzo
  3. Ping Zhou
    44 Zhou
  4. Stephen D Nimer
    347 Nimer