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International Journal of Hematology

, Volume 79, Issue 4, pp 364–368 | Cite as

Progressive Myeloma after Thalidomide Therapy in a Patient with Immature Phenotype of Myeloma (Plasma) Cells

  • Yoshiko Okikawa
  • Akira Sakai
  • Yasuo Takimoto
  • Masaaki Noda
  • Jun Imagawa
  • Yuta Katayama
  • Yoshiaki Kuroda
  • Hajime Okita
  • Kingo Fujimura
  • Akiro Kimuraa
Case Report

Abstract

In our experience with thalidomide treatment for refractory multiple myeloma (MM), most patients with progressive disease (PD) did not show an increase in M-protein despite the tumor burden of myeloma cells. This finding led us to suspect that proliferation of immature myeloma cells showing MPC-1-/CD49e- phenotype may be a sign of PD. We report the results of consecutive analysis of the phenotype of myeloma (plasma) cells in an MM patient with PD during treatment with thalidomide. The myeloma cells decreased by thalidomide therapy were mature (MPC-1+/CD49e+) and intermediate (MPC-1+/CD49e-) types. When the patient was in the PD state, extramedullary plasmacytoma was recognized without proliferation of myeloma cells in the bone marrow (BM). The phenotype of myeloma (plasma) cells in both of these locations was that of immature myeloma cells (MPC-1-/CD49e-), and they showed decreased intensity of CD38 expression. The level of immunoglobulin G (IgG) in serum was decreased, and myeloma (plasma) cells in BM did not increase in PD. Although these clinical features may not be specific to MM patients in PD undergoing treatment with thalidomide, we suggest that immature myeloma cells may be resistant to thalidomide.

Key words

Myeloma cells Thalidomide MPC-1 CD49e 

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Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Yoshiko Okikawa
    • 1
  • Akira Sakai
    • 1
  • Yasuo Takimoto
    • 1
  • Masaaki Noda
    • 2
  • Jun Imagawa
    • 2
  • Yuta Katayama
    • 2
  • Yoshiaki Kuroda
    • 2
  • Hajime Okita
    • 3
  • Kingo Fujimura
    • 3
  • Akiro Kimuraa
    • 3
  1. 1.Department of Hematology and Oncology, Division of Clinical Research, Research Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
  2. 2.Internal MedicineOtake National HospitalOtakeJapan
  3. 3.Department of Clinical Pharmaceutical Science, Graduate School of MedicineHiroshima UniversityHiroshimaJapan

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