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Hématologie

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Phagocytic myeloma cells: report of a case and review of the literature Volume 23, issue 1, Janvier-Février 2017

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Authors
1 Laboratoire d’hématologie
hôpital Lariboisière-Fernand-Widal, Paris
2 Laboratoire de pathologie
hôpital Saint-Louis, Paris
3 Service d’immunohématologie
hôpital Saint-Louis, Paris
4 Laboratoire d’hématologie
hôpital Saint-Louis, Paris
* Tirés à part

Phagocytosis of blood cells by malignant plasma cells in multiple myelome is an extremely rare condition. We report the case of a 75 years-old woman presented with pancytopenia. Bone marrow aspiration revealed an infiltrate of atypical plasma cells and 20% of them contained phagocytosed red blood cells, erythroid progenitors. Laboratory values for calcium, blood urea, creatinin, lactate deshydrogenase were normal. Osteolytic lesions were absent. On the basis of the few reported cases, hemophagocytosis does not appear to be associated with a particular clinical presentation, nor with any biological characteristics. The hemophagocytosis mechanism in myeloma is unknown. In vitro studies have demonstrated the phagocytic potential of myeloma cells. Aberrant CD15 expression might be related to phagocytic function of plasma cells. It has been shown that myeloma cells act as antigen-presenting immature cells with hemophagocytosis activity. This case report highlights the relevance of investigating hemophagocytosis activity by plasmocytes in case of pancytopenia. Further studies are needed to explain the pathophysiology.