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Sydney 2005:
Unconventional Switched Bone Marrow Plasma Cells with Ig V-region Mutations
By Ian MacLennan, MD
Dr. MacLennan presented on unconventional switched bone marrow plasma cells With Ig V-region mutations and provided a summary on multiple myeloma (MM), where tumor cells are found in the bone marrow. These tumor plasma cells produce antibodies via what may be classified as traditional or non-traditional (alternative) pathways. The presence of alternative antibody production pathways is supported by responses seen following rituximab treatment of patients with various autoimmune diseases. In these patients, rituximab sensitive and rituximab non-sensitive plasma cells are seen. Then the question arises as to which of these cells (rituximab sensitive or rituximab insensitive) may be involved in the origin of MM. Dr. MacLennan reviewed studies addressing traditional and alternative pathways for antibody production. Some studies show that cells producing antibodies (B-cell memory clones) respond to various triggers and that these cells can undergo mutations. Other studies show that there are alternate sources of tumor plasma cells and suggest that both traditional and non-traditional pathways for producing antibodies exist.

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