@article{Roberto J. Pessoa de Magalhães_María-Belén Vidriales_Bruno Paiva_Carlos Fernandez-Gimenez_Ramón García-Sanz_Maria-Victoria Mateos_Norma C. Gutierrez_Quentin Lecrevisse_Juan F Blanco_Jose Hernández_Natalia de las Heras_Joaquin Martinez-Lopez_Monica Roig_Elaine Sobral Costa_Enrique M. Ocio_Martin Perez-Andres_Angelo Maiolino_Marcio Nucci_Javier De La Rubia_Juan-Jose Lahuerta_Jesús F. San-Miguel_Alberto Orfao_2012, place={Pavia, Italy}, title={Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry}, volume={98}, url={https://haematologica.org/article/view/6540}, DOI={10.3324/haematol.2012.067272}, abstractNote={Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8<sup>+</sup&gt; T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes favoring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance.}, number={1}, journal={Haematologica}, author={Roberto J. Pessoa de Magalhães and María-Belén Vidriales and Bruno Paiva and Carlos Fernandez-Gimenez and Ramón García-Sanz and Maria-Victoria Mateos and Norma C. Gutierrez and Quentin Lecrevisse and Juan F Blanco and Jose Hernández and Natalia de las Heras and Joaquin Martinez-Lopez and Monica Roig and Elaine Sobral Costa and Enrique M. Ocio and Martin Perez-Andres and Angelo Maiolino and Marcio Nucci and Javier De La Rubia and Juan-Jose Lahuerta and Jesús F. San-Miguel and Alberto Orfao}, year={2012}, month={Dec.}, pages={79-86} }