Vnitr Lek 2008, 54(1):31-35

Assessment of plasmatic cell proliferation and apoptosis indexes in the course of multiple myeloma

J. Minařík^1,*, V. Ščudla¹, M. Ordeltová², J. Bačovský¹, M. Zemanová¹, T. Pika¹

¹ III. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Vlastimil Ščudla, CSc.

² Oddělení alergologie a klinické imunologie Lékařské fakulty UP a FN Olomouc, přednosta doc. MUDr. Jaromír Bystroň, CSc.

Introduction:
The proliferation and apoptosis indexes are a significant prognostic factor in multiple myeloma (MM). The objective of the study was to assess the indexes in the course of MM from the point of view of the disease activity and potential clinical use.

Method:
A sample of 120 patients was studies, of which 49 at diagnosis, 36 in progression and 35 in remission. The proliferation and apoptosis indexes were assessed according to the achieved treatment response and were compared with subsequent progression in patients in remission. The proliferation potential was measured with the propidium-iodide index (PC-PI/CD138), apoptosis was measured with annexine-V (PC-AI/CD138), assessed by the method of flow cytometry.

Results:
The sample of 49 newly diagnosed patients recorded a decrease in PC-PI (M 2.9-2.1, p < 0.0001) and an increase in PC-Al (M 4.7-8.6, p < 0.0001) at remission. Patients without treatment response showed no difference in PC-PI (p = NS), while PC-Al decreased (M 6.2-3.9, p = 0.004). The sample of 36 patients in MM progression with treatment response recorded a decrease in PC-PI (M 2.9-2.2, p < 0.0001) and an increase in PC-Al (M 4.6-8.8, p < 0.019). There was no difference in any of the indicators (p = NS) in cases with zero treatment response. 35 patients in remission with developing progression recorded an increase in PC-Pl (M 2.3-2.7, p < 0.0001) and a decrease in PC-Al (M 8.3-4.2, p < 0.0001).

Conclusion:
The study has shown that monitoring PC-Pl and PC-Al in the course of different phases of MM is beneficial from the point of view of the assessment of changes in the proliferation activity and the degree of apoptosis of myeloma cells. Monitoring the two parametres allows for timely prediction of disease progression.

Keywords: multiple myeloma; myeloma plasmocytes; proliferation index; apoptosis index; myeloma activity

Received: July 30, 2007; Accepted: September 30, 2007; Published: January 1, 2008  Show citation