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AUTHORS: D. Joshua, R. Brown, D. Sze, P.J. Ho, J. Gibson
University of Sydney, Royal Prince Alfred and Concord Hospital, Camperdown, Australia
by Lynne Lederman, PhD
The presence of T-cell clones in myeloma may be related to progression and response. T-cells clones other than those normally seen in the elderly were seen in patients in the MM6 study of thalidomide maintenance following autologous transplant. Thalidomide contributed to OS and progression free survival (PFS), as did the development of T-cell clones. The percentage of patients with clones increased from 48% pre transplant to 96% post transplant. However, what these clones do is unknown, although they are expected to be involved in immune stimulation. T-regulatory cells (T reg) are involved in immune responses to infections and tumors. There is disagreement about whether this cell type is decreased or normal in numbers in myeloma, and whether these cells are functional or not. Dr. Joshua believes that in myeloma CD4 an CD8 T-cells acquire new cell surface antigens, and that this, in combination with dysfunctional T-reg cells may be responsible for the immune defects seen in T-cells in myeloma.