Nutritional aspects in autoimmune diseases undergoing hematopoietic stem cell transplantation: overview and recommendations on behalf of the EBMT ADWP and Nurses Group.

Autoimmune diseases (ADs) represent a heterogeneous group of conditions affecting 5-10% of the global population. In recent decades, hematopoietic stem cell transplant (HSCT), mainly autologous, has been successfully adopted to treat patients affected by severe/refractory ADs. In this context malnutrition has a detrimental impact on relapse, mortality, infection rate, engraftment, long-term survival, and prolongation of hospitalization.

Mixed lymphocyte reaction in human monoclonal gammopathies.

Ten multiple myeloma (MM) and 5 monoclonal gammopathies of undetermined significance (MGUS) were studied. The mixed lymphocyte reaction (MLR) proliferative response was of the same order of magnitude in MM and in MGUS as in normal controls. Normal results were obtained when pathological lymphocytes were used as either responding or stimulating cells.

The idiotypic specificities of lymphocytes in human monoclonal gammopathies: analysis with the fluorescence activated cell sorter.

Four monoclonal IgG kappa gammopathies were studied with anti-idiotypic sera and the percentage of lymphocytes bearing such idiotypes was evaluated with a fluorescence activated cell sorter (FACS). A large percentage (10-15%) of peripheral lymphocytes bearing receptors with the same idiotypic specificities as the M component was observed in multiple myeloma (MM) and in monoclonal gammopathy of undetermined significance (MGUS), suggesting a malignant origin for both these diseases. Capping-endocytosis and resynthesis experiments showed that these idiotypic receptors were not simply adsorbed on the cell membrane, but actually synthesized by the cells bearing them.

Human myeloma: kinetics of the remission phase.

The kinetics of myeloma cells at diagnosis and during complete remission were compared on 4 IgG K patients. We were able to study experimentally the kinetics of the minimal tumor mass because we prepared anti-idiotypic sera specifically directed against the hypervariable region of the M protein. We have shown that the residual myeloma cell labelling index during remission is usually lower than that observable on diagnosis.

Monitoring of a long survival myeloma patient.

Monitoring with anti-idiotypic sera has been applied to identify tumoral cells in a myeloma patient still alive in complete remission 9 years after diagnosis. Monoclonal plasma cells displayed a labeling index that decreased in complete remission below 1%. The great majority of B lymphocytes belonged to the tumoral clone even in complete remission and were therefore not affected by conventional chemotherapy.

Common human melanoma-associated antigen(s) detected by monoclonal antibodies.

Hybridoma cells have been derived from a fusion between mouse myeloma cells (P3-NSI/1Ag4) and spleen cells from a mouse immunized with membrane-enriched fractions from the human melanoma cell line Me-43. Of the 26 hybrids obtained, seven secreted antibodies which reacted with the melanoma cell line used for immunoassay. The specificity of the antibodies produced by the seven positive hybrids was further investigated on 16 melanoma cell lines, 15 other tumors, and 14 lymphoblastoid cell lines.