Fas/Apo-1 (CD95)-mediated and CD95-independent apoptosis of malignant plasma cells

CD95 (Fas/Apo-1) mediates apoptosis in cells of various types. Expression of CD95 and its function were investigated in myeloma cells and most plasma cell lines have been found to be CD95-positive. Anti-CD95 antibody induced apoptosis in these cell lines in a manner dependent on intensity of CD95 expression. Bel-2 expression levels in these cell lines were not correlated with sensitivity to CD95-induced apoptosis. Myeloma cells from approximately 70% of cases analyzed expressed CD95, suggesting a high frequency of CD95 expression of myeloma cells. The incidence of CD95 expression in samples from extramedullary lesions were higher than those of bone marrow myeloma cells. Anti-CD95 antibody did not induce apoptosis in some freshly isolated myeloma cells despite the expression of CD95 induced apoptosis in myeloma cell lines in a manner dependent on intensity of CD95 expression. In fresh samples, intensity of CD95 expression was not correlated with apoptosis evoked by anti-CD95 antibody. Interestingly, isolated myeloma cells with an high-level expression of CD95 showed spontaneous apoptosis during in vitro incubation. This was observed in samples from cases with high serum levels of lactate dehydrogenase (LDH), suggesting that the LDH was derived from cells undergoing spontaneous apoptosis in vivo. Taken together, CD95 is expressed in most myeloma cell lines and in many freshly isolated myeloma cells. However, some of the latter escape from CD95-dependent apoptosis despite the expression of CD95. Moreover, some myeloma cells from cases with aggressive disease may undergo apoptosis in a CD95-independent manner. In this review, the significance of CD95 and apoptosis of myeloma cells are discussed.