Kinetics of tumor growth and regression in IgG multiple myeloma
Open Access
- 1 July 1972
- journal article
- Published by American Society for Clinical Investigation in Journal of Clinical Investigation
- Vol. 51 (7) , 1697-1708
- https://doi.org/10.1172/jci106971
Abstract
Studies of immunoglobulin synthesis, total body tumor cell number, and tumor kinetics were carried out in a series of patients with IgG multiple myeloma. The changes in tumor size associated with tumor growth or with regression were underestimated when the concentration of serum M-component was used as the sole index of tumor mass. Calculation of the total body M-component synthetic rate (corrected for concentration-dependent changes in IgG metabolism) and tumor cell number gave a more accurate and predictable estimate of changes in tumor size. Tumor growth and drug-induced tumor regression were found to follow Gompertzian kinetics, with progressive retardation of the rate of change of tumor size in both of these circumstances. This retardation effect, describable with a constant α, may be caused by a shift in the proportion of tumor cells in the proliferative cycle. Drug sensitivity of the tumor could be described quantitatively with a calculation of BO, the tumor's initial sensitivity to a given drug regimen. Of particular clinical significance, the magnitude of a given patient's tumor regression could be predicted from the ratio of BO to α. Mathematical proof was obtained that the retardation constant determined during tumor regression also applied to the earlier period of tumor growth, and this constant was used to reconstruct the preclinical history of disease. In the average patient, fewer than 5 yr elapse from the initial tumor cell doubling to its clinical presentation with from 1011 to more than 1012 myeloma cells in the body. The reduction in total body tumor mass in most patients responding to therapy ranges from less than one to almost two orders of magnitude. Application of predictive kinetic analysis to the design of sequential drug regimens may lead to further improvement in the treatment of multiple myeloma and other tumors with similar growth characteristics.Keywords
This publication has 33 references indexed in Scilit:
- Total body irradiation for myelomatosis.BMJ, 1971
- Modes of escape from therapeutic control in myelomatosis.BMJ, 1971
- Immunocytoma o' mice an' men.BMJ, 1971
- Immunoglobulin synthesis and total body tumor cell number in IgG multiple myelomaJournal of Clinical Investigation, 1970
- Immunoglobulin Production: Method for Quantitatively Detecting Variant Myeloma CellsScience, 1970
- Treatment for multiple myeloma. Combination chemotherapy with different melphalan dose regimensJAMA, 1969
- Immunochemical Classes of Myelomatosis. INCLUDING DATA FROM A THERAPEUTIC TRIAL CONDUCTED BY A MEDICAL RESEARCH COUNCIL WORKING PARTY*British Journal of Haematology, 1969
- Growth Rates and Responses to Treatment in Human MyelomatosisBritish Journal of Haematology, 1969
- Myeloma Proteins and the Clinical Response to Melphalan TherapyScience, 1965
- Infection, antibody response and gamma globulin components in multiple myeloma and macroglobulinemiaThe American Journal of Medicine, 1963