BACKGROUND Induction therapy of multiple myeloma patients prior to autologous stem cell transplantation has changed from conventional chemotherapy to treatment based on proteasome inhibitors or immunomodulatory drugs. We used flow cytometry to analyze total monocyte and monocyte subset (classical, intermediate and non-classical monocytes) peripheral blood levels before and following auto-transplantation for a consecutive group of myeloma patients who had received the presently used induction therapy. RESULTS The patients showed normal total monocyte concentrations after induction/stem cell mobilization, but the concentrations of classical monocytes were increased compared with healthy controls. Melphalan conditioning reduced the levels of total CD14+ as well as classical and non-classical monocytes, whereas intermediate monocytes were not affected. Thus, melphalan has a non-random effect on monocyte subsets. Melphalan had a stronger effect on total and classical monocyte concentrations for those patients who had received induction therapy including immunomodulatory drugs. Total monocytes and monocyte subset concentrations decreased during the period of pancytopenia, but monocyte reconstitution occurred before hematopoietic reconstitution. However, the fractions of various monocyte subsets varied considerably between patients. CONCLUSIONS The total level of circulating monocytes is normalized early after auto-transplantation for multiple myeloma, but pre- and post-transplant levels of various monocyte subsets show considerable variation between patients.

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多发性骨髓瘤患者接受自体干细胞移植后的循环单核细胞亚群-连续患者在移植后重建之前的预处理状况和病程的研究。

背景技术在自体干细胞移植之前对多发性骨髓瘤患者的诱导治疗已从常规化学疗法变为基于蛋白酶体抑制剂或免疫调节药物的治疗。我们使用流式细胞仪分析了连续移植的接受了目前使用的诱导治疗的骨髓瘤患者在自动移植前后的总单核细胞和单核细胞亚群（经典，中间和非经典单核细胞）外周血水平。结果诱导/干细胞动员后，患者总单核细胞浓度正常，但与健康对照组相比，经典单核细胞浓度增加。Melphalan调节降低了总CD14 +以及经典和非经典单核细胞的水平，而中间单核细胞不受影响。因此，美法仑对单核细胞亚群具有非随机作用。对于接受了包括免疫调节药物在内的诱导治疗的患者，美法仑对总和经典单核细胞浓度的影响更大。在全血细胞减少症期间，总单核细胞和单核细胞亚群浓度降低，但在造血重建之前发生单核细胞重建。但是，患者之间各种单核细胞亚群的比例差异很大。结论多发性骨髓瘤自体移植后早期循环单核细胞的总水平正常化，但是不同患者之间单核细胞亚群的移植前和移植后水平显示出相当大的差异。对于接受了包括免疫调节药物在内的诱导治疗的患者，美法仑对总和经典单核细胞浓度的影响更大。在全血细胞减少症期间，总单核细胞和单核细胞亚群浓度降低，但在造血重建之前发生单核细胞重建。但是，患者之间各种单核细胞亚群的比例差异很大。结论多发性骨髓瘤自体移植后早期循环单核细胞的总水平正常化，但是不同患者之间单核细胞亚群的移植前和移植后水平显示出相当大的差异。对于接受了包括免疫调节药物在内的诱导治疗的患者，美法仑对总和经典单核细胞浓度的影响更大。在全血细胞减少症期间，总单核细胞和单核细胞亚群浓度降低，但在造血重建之前发生单核细胞重建。但是，患者之间各种单核细胞亚群的比例差异很大。结论多发性骨髓瘤自体移植后早期循环单核细胞的总水平正常化，但是不同患者之间单核细胞亚群的移植前和移植后水平显示出相当大的差异。在全血细胞减少症期间，总单核细胞和单核细胞亚群浓度降低，但在造血重建之前发生单核细胞重建。但是，患者之间各种单核细胞亚群的比例差异很大。结论多发性骨髓瘤自体移植后早期循环单核细胞的总水平已正常化，但不同患者之间单核细胞亚群的移植前和移植后水平显示出相当大的差异。在全血细胞减少症期间，总单核细胞和单核细胞亚群浓度降低，但在造血重建之前发生单核细胞重建。但是，患者之间各种单核细胞亚群的比例差异很大。结论多发性骨髓瘤自体移植后早期循环单核细胞的总水平正常化，但是不同患者之间单核细胞亚群的移植前和移植后水平显示出相当大的差异。