Document Detail

Oligoclonal bands and immunoglobulin isotype switch during monitoring of patients with multiple myeloma and autologous hematopoietic cell transplantation: a 16-year experience.
MedLine Citation:
PMID:  20450334     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Over the last 20 years, high dose therapy followed by hemopoietic stem cell transplantation has been employed in patients with multiple myeloma (MM). During 16 years of follow-up, the degree of tumor response and survival in 238 patients with autologous stem cell transplantation (ASCT) and changes in the serum protein electrophoretic pattern were analyzed. METHODS: Agarose gel electrophoresis with densitometric analysis and immunofixation were performed to evaluate serum monoclonal protein. IgM, IgA, IgG and beta(2)-microglobulin (beta2M) were quantitated. Urine protein electrophoresis with IF was performed on cellulose acetate gel using colloidal silver staining without concentrating. RESULTS: After 34 months of follow-up (range 1-160 months), eight patients (3.4%) showed a distinct monoclonal protein band that was different from their original isotype switch. This was observed to be a transient phenomenon (22.2 months). Thirty-seven patients (15.5%) developed oligoclonal bands (OB) between the first and the twentieth month after ASCT (mean 4.4 months), which persisted for 7.9 months (1-36 months). The mean overall survival time was statistically different (p<0.05) between the group with OB and the group without them. Mean values of serum albumin, beta2M, and non-involved immunoglobulins did not show statistical differences. CONCLUSIONS: The occurrence of OB could be a potential favorable prognostic marker after transplantation due to the prolonged survival observed. Close follow-up of anomalous protein bands, either in serum or urine, is essential due to the additional difficulty in interpretation when the therapeutic response and evolution are evaluated.
Mariel Emilce Alejandre; Leticia Bibiana Madalena; Miguel Arturo Pavlovsky; Maria Laura Facio; Claudia Corrado; Gustavo Milone; Pablo Diego Bresciani; Susana Alicia Fraind; Santiago Pavlovsky; Marco Antonio Pizzolato
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  48     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  727-31     Citation Subset:  IM    
Department of Clinical Biochemistry, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina.
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MeSH Terms
Biological Markers / blood
Electrophoresis, Agar Gel
Follow-Up Studies
Hematopoietic Stem Cell Transplantation*
Immunoglobulin Isotypes / blood*
Isoelectric Focusing
Middle Aged
Multiple Myeloma / diagnosis,  mortality,  therapy*
Oligoclonal Bands / blood*
Transplantation, Autologous
Reg. No./Substance:
0/Biological Markers; 0/Immunoglobulin Isotypes; 0/Oligoclonal Bands

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