Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1983 Sep;72(3):853–861. doi: 10.1172/JCI111056

Marrow cytometry and prognosis in myeloma.

B Barlogie, R Alexanian, E A Gehan, L Smallwood, T Smith, B Drewinko
PMCID: PMC1129250  PMID: 6193144

Abstract

We have previously shown that flow cytometric analysis of acridine orange-stained bone marrow cells is useful for the objective enumeration and characterization of plasma cells from patients with myeloma, frequently exhibiting an abnormal DNA and an elevated RNA content. In this report on 77 previously untreated patients, we have investigated the biologic and prognostic implications of these quantitative tumor cell parameters. The degree of marrow involvement by tumor, both by microscopic and cytometric analysis, correlated with the clinically derived tumor mass stage. Examination of the product of relative tumor cell RNA content and marrow tumor infiltrate (as a measure of metabolic capacity for immunoglobulin production) in relationship to the myeloma protein concentration in the serum revealed differences in the efficiency of immunoglobulin production and/or catabolism. There was an inverse relationship between the degree of marrow tumor involvement and RNA index, suggesting a more aggressive behavior of myeloma in patients with a low tumor cell RNA content. Prognostically, high tumor cell RNA content identified patients with a high likelihood of response to both initial treatment (32 patients, P = 0.004) and salvage therapy (29 patients, P = 0.01). Favorable factors for survival were low clinical tumor mass stage (P = 0.07) and low marrow tumor infiltrate as determined morphologically (P = 0.04) and cytometrically (P = 0.004). Thus, the direct examination of marrow cellular DNA and RNA content permitted assessment of tumor burden and was useful in the prediction of response and survival.

Full text

PDF
853

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexanian R., Balcerzak S., Bonnet J. D., Gehan E. A., Haut A., Hewlett J. S., Monto R. W. Prognostic factors in multiple myeloma. Cancer. 1975 Oct;36(4):1192–1201. doi: 10.1002/1097-0142(197510)36:4<1192::aid-cncr2820360403>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  2. Alexanian R. Localized and indolent myeloma. Blood. 1980 Sep;56(3):521–525. [PubMed] [Google Scholar]
  3. Alexanian R., Salmon S., Gutterman J., Dixon D., Bonnet J., Haut A. Chemoimmunotherapy for multiple myeloma. Cancer. 1981 Apr 15;47(8):1923–1929. doi: 10.1002/1097-0142(19810415)47:8<1923::aid-cncr2820470802>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  4. Barlogie B., Latreille J., Freireich E. J., Fu C. T., Mellard D., Meistrich M., Andreeff M. Characterization of hematologic malignancies by flow cytometry. Blood Cells. 1980;6(4):719–744. [PubMed] [Google Scholar]
  5. Barlogie B., Spitzer G., Hart J. S., Johnston D. A., Büchner T., Schumann J., Drewinko B. DNA histogram analysis of human hemopoietic cells. Blood. 1976 Aug;48(2):245–258. [PubMed] [Google Scholar]
  6. Durie B. G., Salmon S. E., Moon T. E. Pretreatment tumor mass, cell kinetics, and prognosis in multiple myeloma. Blood. 1980 Mar;55(3):364–372. [PubMed] [Google Scholar]
  7. Durie B. G., Salmon S. E. The current status and future prospects of treatment for multiple myeloma. Clin Haematol. 1982 Feb;11(1):181–210. [PubMed] [Google Scholar]
  8. GEHAN E. A. A GENERALIZED WILCOXON TEST FOR COMPARING ARBITRARILY SINGLY-CENSORED SAMPLES. Biometrika. 1965 Jun;52:203–223. [PubMed] [Google Scholar]
  9. Goldie J. H., Coldman A. J. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep. 1979 Nov-Dec;63(11-12):1727–1733. [PubMed] [Google Scholar]
  10. Hofmann V., Salmon S. E., Durie B. G. Drug resistance in multiple myeloma associated with high in vitro incorporation of 3H-thymidine. Blood. 1981 Sep;58(3):471–476. [PubMed] [Google Scholar]
  11. Keating M. J., Smith T. L., Gehan E. A., McCredie K. B., Bodey G. P., Spitzer G., Hersh E., Gutterman J., Freireich E. J. Factors related to length of complete remission in adult acute leukemia. Cancer. 1980 Apr 15;45(8):2017–2029. doi: 10.1002/1097-0142(19800415)45:8<2017::aid-cncr2820450806>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  12. Latreille J., Barlogie B., Dosik G., Johnston D. A., Drewinko B., Alexanian R. Cellular DNA content as a marker of human multiple myeloma. Blood. 1980 Mar;55(3):403–408. [PubMed] [Google Scholar]
  13. Latreille J., Barlogie B., Johnston D., Drewinko B., Alexanian R. Ploidy and proliferative characteristics in monoclonal gammopathies. Blood. 1982 Jan;59(1):43–51. [PubMed] [Google Scholar]
  14. Preud'homme J. L., Labaume S., Praloran V. Synthesis of abnormal heavy chains in Bence-Jones plasma cell leukemia with intracellular IgG. Blood. 1980 Dec;56(6):1136–1140. [PubMed] [Google Scholar]
  15. Traganos F., Darzynkiewicz Z., Sharpless T., Melamed M. R. Simultaneous staining of ribonucleic and deoxyribonucleic acids in unfixed cells using acridine orange in a flow cytofluorometric system. J Histochem Cytochem. 1977 Jan;25(1):46–56. doi: 10.1177/25.1.64567. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES