[Heterogenicity of the response to chemotherapy in plasmablastic myeloma]

Several recent studies have identified in multiple myeloma a plasmablastic subgroup characterized by its very sombre prognostic. We report the results of treatment in 10 high risk patients with plasmablastic myeloma stage IIIA in the Durie and Salmon classification, stage III in the Bartl classification (tumoral mass greater than 50%). The median survival of the 10 patients was 8 months. These patients, who were resistant to melphalan-prednisone (M-P) or to VMCP in conventional doses, fell into 2 categories: those who responded to chemotherapy with adriamycin, and those who resisted all types of chemotherapy from the start. The finding of such heterogeneous responses to chemotherapy in the plasmablastic subgroup of multiple myeloma and the usefulness of CALLA+ antigen determination make it necessary to study cell differentiation antigens, which would in the long term alter the therapeutic approach in these patients.