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2009, Number 4

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Rev Mex Patol Clin Med Lab 2009; 56 (4)

Determination of apoptosis markers in patients with novo multiple myeloma

Gutiérrez HR

Language: Spanish
References: 40
Page: 235-246
PDF size: 141.35 Kb.


ABSTRACT

Background: Multiple myeloma is a plasma cells malignancy, represents about 1% of all malignancies and 10% of hematological malignancies. In United States there are 14,000 annual cases. In Mexico there are 0.4 new cases per 100, 000 people, with a mean survival of 24-36 months depending on prognostic factors associated with the disease, some are specific markers and can be present in cells patients tumor at diagnosis. Actually, there are proposals to new prognostic factors, including the expression of CD200 and its association with apoptosis to induction of immune intolerance; that is the importance of identifying apoptotic markers (annexin V, Bcl-2, caspase 3, and CD95) in bone marrow of patients with myeloma using flow cytometry. Objective: To quantify apoptosis marker annexin V, Bcl-2, caspase 3, CD95, using flow cytometry in samples of bone marrow (BM) in patients with novo multiple myeloma. Material and method: Transversal, prospective study conducted at «La Raza» National Medical Center in México. Twenty two patients were admitted between May 1st and October 31th 2008 with diagnosis of de novo multiple myeloma at hematology service. We quantify marker of apoptosis (annexin V, Bcl-2, caspase 3, CD95) and CD200 using a flow cytometer from Becton Dickinson FACSCalibur model in the program «Cell Quest Pro». Results: We included 22 patients. The identification of markers was performed in 15 patients because 7 samples were coagulated. The frequency by sex was 72.7% males and 27.3% female, mean age of 59.13 years, median 60 years. The determination of markers of apoptosis Bcl-2 was found high 59.95%, low 40.5% patients; caspase 3 high 80.0%, normal 20.0% patients;, normal CD38 6.7% in patient, high in 93.6%; CD138 normal 33.3%, high 66.57%; CD95 high 26.63% and normal 73.37%. Correlation coefficient between the expression of CD200 and CD95 was that the higher expression of CD200 increased expression of CD95 with p ‹ 0.043; too 45.5% patients were doubly positive for CD38 and CD138. Conclusions: b> Of the variables analyzed statistically significant difference was found in the relationship between the expression of CD200 and CD95 and found that a higher expression of CD200 increased expression of CD95. Other important finding was patients with doubly positive for CD38 and CD138 correspond to 67%. The correlation between Bcl2 and CD138 increased Bcl2 see that at least CD138. It is important to increase the sample size and follow-up time at least 3 years to evaluate survival and prognostic markers of apoptosis in relation to the outcome of the disease. Establish benchmarks of CD200 and annexin V in healthy population.


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