Tinatin Muradashvili, Yuxin Liu, Jennifer VanOudenhove, Sean X Gu, Diane S Krause, Francesca Montanari, Maximillian J Carlino, Rubia Mancuso, Jessica M Stempel, Stephanie Halene, Amer M Zeidan, Nikolai A Podoltsev, Natalia Neparidze
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引用次数: 0
摘要
我们研究了并发获得性再生障碍性贫血(AA)的多发性骨髓瘤(MM)患者的免疫细胞减少症,重点研究了接受血浆细胞导向疗法治疗的三个临床病例。三位患者的骨髓瘤均获得部分应答,其中一位患者的再生障碍性贫血完全缓解。两名患者的输血需求得到部分改善,但仍患有严重的再生障碍性贫血,因此接受了免疫抑制疗法(IST),这两名患者的输血需求都得到了改善。这些患者的体外血清检测显示血小板线粒体功能障碍和血小板凋亡,但未显示血清特异性抑制祖细胞中红细胞集落的形成。在患有 AA 的 MM 患者中,IL8 和 IL15 的水平升高,这表明它们在这种并发症中的潜在作用。对 IST 的反应表明,骨髓瘤失调的免疫系统可能导致自身反应性 T 细胞破坏造血干细胞和祖细胞,这为开发治疗 MM 细胞减少症的新疗法提供了启示。
Aplastic anemia in association with multiple myeloma: clinical and pathophysiological insights.
We investigated immune cytopenia in multiple myeloma (MM) patients with concurrent acquired aplastic anemia (AA), focusing on three clinical cases treated with plasma cell-directed therapy. All three patients achieved partial response in MM and one patient experienced complete resolution of AA. Two patients had partial improvement in transfusion requirement but continued to suffer from severe AA, leading to immunosuppressive therapy (IST) with improvement of transfusion requirement in both patients. In vitro serum testing of these patients demonstrated platelet mitochondrial dysfunction and platelet apoptosis but did not show sera-specific inhibition of erythroid colony formation in progenitor cells. The levels of IL8 and IL15 were elevated in MM patients with AA, implicating their potential roles in this co-occurrence. Response to IST points to the possibility of myeloma-dysregulated immune system leading to autoreactive T-cell destruction of hematopoietic stem and progenitor cells, offering insights for developing new treatment for cytopenia in MM.
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor