The low proliferative activity of myeloma plasma cells prompted the notion
that the clonotypic B cells that exist in the blood and bone marrow of all
myeloma patients contain the proliferative myeloma cells (stem cell). We ha
ve exploited our severe combined immunodeficiency (SCID)-hu host system for
primary myeloma to investigate whether myeloma plasma cells are capable of
sustained proliferation. Purified CD38(++)CD45(-) plasma cells consistentl
y grew and produced myeloma and its manifestations in SCID-hu hosts (8 of 9
experiments). In contrast, the plasma cell-depleted bone marrow cells from
6 patients did not grow or produce myeloma in SCID-hu hosts. Similarly, wh
ereas plasma-cell containing blood cells from 4 patients grew and produced
myeloma in hosts, neither the PC-depleted blood cells from 3 of the patient
s nor a blood specimen that did not contain plasma cells grew in SCID:hu ho
sts, regardless of their CD19-expressing cell contents. Also, in hosts inje
cted with blood cells, although the myeloma cells were able to disseminate
through the murine host system, they were only able to grow in the human bo
nes within a human microenvironment and were not detectable in the murine b
lood or other organs. Interestingly, the circulating plasma cells appear to
grow more avidly in the SCID-hu hosts than their bone marrow counterparts,
suggesting that they represent a subpopulation of the plasma cells in the
bone marrow. Although our studies clearly demonstrate the proliferative pot
ential of myeloma plasma cells, they are suggestive, not conclusive, as to
the existence of a preplasmacytic myeloma progenitor cell. (C) 1999 by The
American Society of Hematology.