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Demonstration of changes in plasma cell subsets in multiple myeloma

From the Department of Immunology, St. Helier Hospital, Carshalton, Surrey, UK (MJA); Section of Haemato-Oncology, The Royal Marsden NHS Foundation Trust, UK (FED, DdC, GJM)

Correspondence: Michael J. Ayliffe, Department of Immunology, St Helier Hospital Wrythe Lane, Carshalton, Surrey, SM3 8NR, UK. E-mail: michael.ayliffe{at}onetel.net

Increases in free light chain (FLC) production are associated with disease progression in multiple myeloma (MM). Using a double immunofluorescence staining method to produce a differential count of plasma cells in bone marrow, single populations were demonstrated, containing intact monoclonal immunoglobulins (M-Igs) in 74% and FLCs only in 8% of cases. However, 18% contained a mixture of both cell populations. Progression from cells making intact M-Ig to cells restricted to FLC only production occurred in individual cases during the course of their disease. The presence of FLC only cells was associated with shortened survival.

Key words: multiple myeloma, bone marrow, plasma cells, free light chains, monoclonal immunoglobulins.