TRANSPLANT LABORATORY

We have been interested to assess the efficacy of CD34⁺ selection and double high dose therapy in removing malignant cell from PBSC autografts in multiple myeloma. While most current treatments for multiple myeloma are effective in eradicating malignant plasma cells the disease persists. To achieve cure it is essential that the cell responsible for initiating and spreading the disease – the myeloma progenitor cell – be identified and targeted by treatments. To generate sufficient cellular material for these studies we are cryopreserving and immunophenotyping bone marrow and peripheral blood cells (from diagnosis onwards) from all multiple myeloma patients treated at our institution. We aim to transplant these cells and flow-sorted subsets into SCID/NOD mice to determine the cells responsible for generation of myeloma in the mice and the time course of disease progression. With the cooperation of Professor Linda Pilarski we are establishing an in situ RT-PCR method using patient-specific immunoglobulin gene sequences to identify cells belonging to the myeloma clone. This technique is essential for our studies. It will make it possible for us to quantitate residual disease in the patient cells throughout the course of treatment and to phenotypically characterise these cell. This will facilitate the development of an improved treatment protocol. In addition, this methodology will be applied to specifically identify patient cells in mice following transplantation.