Haematologica 2003 - Supplements

Recognition of these antigens appears to be limited in cancer
patients. This is caused by different mechanisms: deficiencies of
antigen processing and recognition, or an antigen expression
below the threshold for immune recognition.
Aim: By upregulating the expression of CTA’s under conditions
potentially reachable in the clinical setting, a higher
immunogenicity could be reached, which is a major advantage in
the setting of immunotherapy.
It has recently been shown that the demethylating agent 5-Aza-
2’-deoxycytidine or decitabine (DAC) can enhance MAGE-3 and
NY-ESO-1 expression in different cell lines.
We tried to determine if this is also true in MM cell lines.
Methods: Seven different cell lines originating from myeloma,
lymphoid malignancy and lung cancer (U266, RPMI8226, Calu-
6, U937, EJM, JJN3 and MMS1) were exposed to DAC at
varying concentrations (0, 0.1, 1 or 10 M) and during different
exposure times (0, 24, 48 and 72 Hrs.). The cultures were
performed in RPMI 1640 media with 10% FBS, 1%
penicilline/streptomycine, 1% L-glutamine and 1% Hepes buffer.
Both MAGE-3 and NY-ESO-1 were evaluated by flowcytometry
(FCM), PCR and quantitative PCR (TaqMan).
Results: 1) We observed an increase of expression of TCA’s in
cell lines U937, HMS1 and U266 after exposure to the
demethylating agent DAC. We’re the first group to report this
finding.
2) NY-ESO-1 and MAGE-3 not only appear to be excellent
candidate proteins for immunotherapy in MM, but their
expression can be significantly upregulated by DAC.
4. From MGUS to symptomatic MM
4.1 Diagnostic guidelines
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Nordic Myeloma Study Group Guidelines on the
Diagnosis and Management of Multiple Myeloma
E Hippe1, M Hjorth2, I Turesson3, J Westin4, F Wisløff5 for
the Nordic Myeloma Study Group
University Hospital of Copenhagen, Herlev1, Lidköping Hospital,
Lidköping2, University Hospital Malmö3, University Hospital Lund4
and Ullevål University Hospital, Oslo5 (E-mail: hippe@dadlnet.dk)
The Nordic Myeloma Study Group (NMSG) is a network of
clinicians and scientists working with myeloma patients and
myeloma research projects within the Nordic countries. The
group was founded in 1987 and today comprises 17 university
clinics and 90 county hospital clinics in Denmark, Norway and
Sweden, covering a population of about 12 million inhabitants.
The aims of the group are: 1) to perform population based clinical
studies to evaluate new therapeutic modalities in patients with
multiple myeloma, with special regard to and their influences on
the quality of life, 2) to study the mechanisms behind and the
manifestations of the disease and 3) to inform and educate
patients and their relatives about the disease and the therapeutic
options available.
In 1995 NMSG first prepared a Nordic health care program
covering all aspects of the diagnosis and care of multiple
myeloma patients. The program was written in the Nordic
languages and widely distributed among the participating clinics.
The NMSG guidelines comprise: 1) Investigation, diagnosis and
indications for treatment, 2) Initial therapy, 3) Treatment of
complications, 4) Supportive care, 5) Management of
relapsed/refractory disease, 6) Aspects of quality of life and
economic avaluation of treatment modalities, and 7) Patient
information. Where possible the guidelines end up in
recommendations based on literature review and consensus of the
NMSG expert opinion.
The guidelines have recently been updated and are from 2002
available on the NMSG homepage (http://www.nordicmyeloma.org).
Also the web-based edition is written in the
Nordic languages. Our recommendations are very similar to the
guidelines later published by the UK Myeloma Forum. In the
near future it would be possible to coordinate the Nordic/UK
guidelines, and also to involve other interested European
countries in the project.
077
Guidelines on the diagnosis and management of
solitary plasmacytoma of bone (SBP) and solitary
extramedullary plasmacytoma (SEP)
R. Soutar, H. Lucraft, A. Reece, J. Bird, G. Jackson, E. Low
and Diana Samson
On behalf of the UK Myeloma Forum (UKMF)
SBP and SEP are rare tumours and most haematologists have
little experience of treating such patients. Guidelines on the
diagnosis and management of SBP and SEP would therefore be
helpful. A working group of the UKMF, including a clinical
oncologist (radiotherapist) and an orthopaedic surgeon, has
drafted evidence-based guidelines. The main recommendations
are as follows:
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