T-cell subsets and myeloma cell mass

Peripheral blood lymphocyte subsets in multiple myeloma and monoclonal gammopathy of undetermined significance

Peripheral blood lymphocyte subsets were analysed by flow cytometry and compared among 43 patients with untreated multiple myeloma (MM), 16 patients with monoclonal gammopathy of undetermined significance (MGUS) and 26 controls. The age and sex distributions of the patients and controls were comparable, which is important, since in the controls there was a significant effect of age and/or sex on the number of CD3+, CD57+, CD8+57+, CD16+ and CD3-56+ lymphocyte subsets, and on the CD4+/CD8+ and CD4+Leu-8+/CD4+ ratios. In MM, the number of CD8+ and CD57+ cells and the CD4+/CD8+ ratio were related to the clinical stage. The number of CD20+, CD3+, CD4+, CD16+ and CD3-56+ cells and the CD3+/CD20+ ratio were significantly different in MM patients compared to age- and sex-matched controls as was the number of CD3+ and CD4+ cells of MGUS patients compared to controls. Further, there were significant differences in the CD3+/CD20+ ratio between MM and MGUS patients and between stage I MM and MGUS. The role of peripheral blood lymphocyte subsets in differentiating monoclonal gammopathies merits further study.

Lymphoid subsets and prognostic factors in multiple myeloma. Cooperative Group for the Study of Monoclonal Gammopathies

In a uniform series of 170 untreated myeloma patients (MM) we investigated the distribution of T cell subsets in peripheral blood (PB) and their relationship with the most relevant disease characteristics, including survival. CD4 cells were significantly decreased both in percentage and absolute numbers (P less than 0.0001). On the other hand, the CD8 cells only showed a slight increase in relative numbers. Upon correlating the abnormalities in the distribution of T cells with other clinical and biological disease characteristics the most remarkable correlation was with survival. A low number of CD4 cells (less than 700 x 10(6)/l) was associated with both an advanced clinical stage and a shorter survival (20 v. 43 months, P = 0.01). Moreover, a significant correlation also exists between the decrease in CD4 cells and both high beta 2-microglobulin (beta 2M) levels and anaemia. On the other hand, no relationship was found with the type of M-component nor with the plasma cell phenotype. Finally multivariate analysis showed that the number of CD4 cells add independent prognostic information to other well-established tests for the assessment of disease outcome in patients with multiple myeloma.

Peripheral blood and bone marrow lymphocyte subsets in patients with multiple myeloma

A panel of monoclonal antibodies (McAb) from the Wu series was used to characterize lymphocyte subsets of peripheral blood (PB) from 9 patients with multiple myeloma (MM) by means of indirect immunofluorescence assay. In 7 of these patients bone marrow (BM) cells were also studied. Abnormal distribution of T lymphocyte subsets was observed in these patients, and the alterations were quite similar in both PB and BM. A significant increase in the proportion of WUT8+ cells (P less than 0.001) and a reduced WuT4/WuT8 ratio (P less than 0.001) were found in patient group. In both PB and BM of patients, WuT10+ cell counts were significantly higher than normal (P less than 0.001). There was a good correlation between BM WuT10+ cells and BM myeloma cells (r = 0.76, P less than 0.05), whereas no correlation was found between PB WuT10+ cells and BM myeloma cells. The significance of abnormal T-cell subset distribution and elevated WuT10+ cells in MM is discussed.