Search tips
Search criteria 


Logo of jcinvestThe Journal of Clinical Investigation
J Clin Invest. 1983 September; 72(3): 853–861.
PMCID: PMC1129250

Marrow cytometry and prognosis in myeloma.


We have previously shown that flow cytometric analysis of acridine orange-stained bone marrow cells is useful for the objective enumeration and characterization of plasma cells from patients with myeloma, frequently exhibiting an abnormal DNA and an elevated RNA content. In this report on 77 previously untreated patients, we have investigated the biologic and prognostic implications of these quantitative tumor cell parameters. The degree of marrow involvement by tumor, both by microscopic and cytometric analysis, correlated with the clinically derived tumor mass stage. Examination of the product of relative tumor cell RNA content and marrow tumor infiltrate (as a measure of metabolic capacity for immunoglobulin production) in relationship to the myeloma protein concentration in the serum revealed differences in the efficiency of immunoglobulin production and/or catabolism. There was an inverse relationship between the degree of marrow tumor involvement and RNA index, suggesting a more aggressive behavior of myeloma in patients with a low tumor cell RNA content. Prognostically, high tumor cell RNA content identified patients with a high likelihood of response to both initial treatment (32 patients, P = 0.004) and salvage therapy (29 patients, P = 0.01). Favorable factors for survival were low clinical tumor mass stage (P = 0.07) and low marrow tumor infiltrate as determined morphologically (P = 0.04) and cytometrically (P = 0.004). Thus, the direct examination of marrow cellular DNA and RNA content permitted assessment of tumor burden and was useful in the prediction of response and survival.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Alexanian R, Balcerzak S, Bonnet JD, Gehan EA, Haut A, Hewlett JS, Monto RW. Prognostic factors in multiple myeloma. Cancer. 1975 Oct;36(4):1192–1201. [PubMed]
  • Durie BG, Salmon SE, Moon TE. Pretreatment tumor mass, cell kinetics, and prognosis in multiple myeloma. Blood. 1980 Mar;55(3):364–372. [PubMed]
  • Latreille J, Barlogie B, Johnston D, Drewinko B, Alexanian R. Ploidy and proliferative characteristics in monoclonal gammopathies. Blood. 1982 Jan;59(1):43–51. [PubMed]
  • Alexanian R, Salmon S, Gutterman J, Dixon D, Bonnet J, Haut A. Chemoimmunotherapy for multiple myeloma. Cancer. 1981 Apr 15;47(8):1923–1929. [PubMed]
  • Hofmann V, Salmon SE, Durie BG. Drug resistance in multiple myeloma associated with high in vitro incorporation of 3H-thymidine. Blood. 1981 Sep;58(3):471–476. [PubMed]
  • Latreille J, Barlogie B, Dosik G, Johnston DA, Drewinko B, Alexanian R. Cellular DNA content as a marker of human multiple myeloma. Blood. 1980 Mar;55(3):403–408. [PubMed]
  • Alexanian R. Localized and indolent myeloma. Blood. 1980 Sep;56(3):521–525. [PubMed]
  • Durie BG, Salmon SE. The current status and future prospects of treatment for multiple myeloma. Clin Haematol. 1982 Feb;11(1):181–210. [PubMed]
  • Barlogie B, Spitzer G, Hart JS, Johnston DA, Büchner T, Schumann J, Drewinko B. DNA histogram analysis of human hemopoietic cells. Blood. 1976 Aug;48(2):245–258. [PubMed]
  • Traganos F, Darzynkiewicz Z, Sharpless T, Melamed MR. Simultaneous staining of ribonucleic and deoxyribonucleic acids in unfixed cells using acridine orange in a flow cytofluorometric system. J Histochem Cytochem. 1977 Jan;25(1):46–56. [PubMed]
  • Barlogie B, Latreille J, Freireich EJ, Fu CT, Mellard D, Meistrich M, Andreeff M. Characterization of hematologic malignancies by flow cytometry. Blood Cells. 1980;6(4):719–744. [PubMed]
  • Preud'homme JL, Labaume S, Praloran V. Synthesis of abnormal heavy chains in Bence-Jones plasma cell leukemia with intracellular IgG. Blood. 1980 Dec;56(6):1136–1140. [PubMed]
  • Goldie JH, Coldman AJ. A mathematic model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep. 1979 Nov-Dec;63(11-12):1727–1733. [PubMed]
  • Keating MJ, Smith TL, Gehan EA, McCredie KB, Bodey GP, Spitzer G, Hersh E, Gutterman J, Freireich EJ. Factors related to length of complete remission in adult acute leukemia. Cancer. 1980 Apr 15;45(8):2017–2029. [PubMed]

Articles from The Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation