Marrow cytometry and prognosis in myeloma.
Marrow cytometry and prognosis in myeloma.
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骨髓瘤的骨髓细胞计数和预后。
DOI：
10.1172/jci111056
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
Drewinko,B
中科院分区：
文献类型：
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作者：
Barlogie,B;Alexanian,R;Gehan,EA;Smallwood,L;Smith,T;Drewinko,B
我们以前已经表明，吖啶橙染色的骨髓细胞的流式细胞术分析是有用的骨髓瘤患者的浆细胞的客观计数和表征，经常表现出异常的DNA和RNA含量升高。在这份报告中，对77例未经治疗的患者，我们研究了这些定量肿瘤细胞参数的生物学和预后意义。通过显微镜和细胞计数分析，肿瘤累及骨髓的程度与临床肿瘤分期相关。检查相对肿瘤细胞RNA含量和骨髓肿瘤浸润（作为免疫球蛋白产生的代谢能力的测量）与血清中骨髓瘤蛋白浓度的关系，发现免疫球蛋白产生和/或catalysts的效率存在差异。骨髓肿瘤累及程度与RNA指数呈负相关，提示肿瘤细胞RNA含量低的患者骨髓瘤更具侵袭性。预后方面，高肿瘤细胞RNA含量的患者对初始治疗（32例患者，P = 0.004）和挽救治疗（29例患者，P = 0.01）的反应可能性较高。生存的有利因素是低临床肿瘤肿块分期（P = 0.07）和低骨髓肿瘤浸润，如形态学（P = 0.04）和细胞计数（P = 0.004）。因此，骨髓细胞DNA和RNA含量的直接检查允许评估肿瘤负荷，并有助于预测反应和生存。
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.