InnoLiPa reverse slot blot hybridization system provided by Murex (Immunogenetics, Zwijndzecht, Belgium). Results were analyzed with the Yates continuity-corrected chi-square test using the GraphPad program. We found that the frequency of the HLA-DRB1*1302 haplotype was 21.43% in the group of patients compared to 2.56% in the controls (P = .0199) (Table 1). The relative risk for the carriers was 8.36. The frequencies of all other HLA haplotypes did not differ significantly between patients and control subjects. The clinical and biologic significance of our finding is unknown, but it seems possible that the frequency of the HLA-DRB1*1302 haplotype may have a role in the develop- ment of the aforementioned unrecognized low-grade chronic inflammation. Associations of HLA haplotypes with chronic inflammatory processes have already been well documented in a variety of clinical disorders. 8 We believe that the increased frequency of the HLA-DRB1*1302 haplotype in NI-CINA patients may indicate the possible genetic basis in the develop- ment of such an inflammation, and thus it may predispose the haplotype-carrying subjects to develop the disorder. Helen A. Papadaki and George D. Eliopoulos Department of Haematology, University of Crete School of Medicine University Hospital of Heraklion, Crete, Greece Stavroula A. Coulocheri Department of Biological Chemistry, University of Athens School of Medicine Athens, Greece Maria Spyropoulou and Cathrin Stavropoulos-Giokas Laboratory of Histocompatibility General Hospital of Athens “G.Gennimatas”, Athens, Greece References 1. Dale DC, Guerry D, Wewerka J, Bull J, Chusid M. Chronic neutropenia. Medi- cine (Baltimore) 1979;58:128-144. 2. Papadaki HA, Xylouri I, Coulocheri S, Kalmanti M, Kafatos A, Eliopoulos GD. Preva- lence of chronic idiopathic neutropenia of adults among an apparently healthy popu- lation living on the island of Crete. Ann Hematol. 1999;78:293-297. 3. Papadaki HA, Coulocheri SA, Eliopoulos GD. Patients with chronic idiopathic neutropenia of adults have increased serum concentrations of inflammatory cytokines and chemokines. Am J Hematol. 2000;65:271-277. 4. Papadaki HA, Giouremou K, Eliopoulos GD. Low frequency of myeloid progeni- tor cells in chronic idiopathic neutropenia of adults may be related to increased production of TGF-1 by bone marrow stromal cells. Eur J Haematol. 1999;63: 154-162. 5. Papadaki HA, Eliopoulos GD. Enhanced neutrophil extravasation may be a contributing factor in the determination of neutropenia in patients with chronic idiopathic neutropenia of adults. Eur J Haematol. 1998;61:272-277. 6. Tongs S, March SGE, Bunce M, et al. HLA class I DNA typing study. In: D. Charron, ed. Genetic Diversity of HLA, Functional and Medical Implications. Paris: EDK Medical and Scientific International Publishers; 1997:119-215. 7. Saiki RK, Walsh Levenson CH, Erlich HA. Genetic analysis of amplified DNA with immobilized sequence-specific oligonucleotide probes. Proc Natl Acad Sci U S A. 1989;86:6230-6234. 8. Brostoff J, Scadding GK, Male D, Roit IM. Clinical Immunology. London: Mosby; 1994;2.1-2.14. To the editor: CD15-expressing phagocytic plasma cells in a patient with multiple myeloma In mammals there are 2 cell types that can phagocytize: macro- phages and neutrophils. Malignant cytophagocytosis is a fulminant disease characterized by phagocytosis of bone marrow cellular elements mainly by marrow macrophages (histiocytes) or rarely by other cells (eg, myeloid blasts). Cytophagocytosis by plasma cells in multiple myeloma is an extremely rare condition. Plasma cells are antibody-producing cells and have no phagocytic func- tion. There are only a few reports describing phagocytic plasma cells in patients with multiple myeloma. 1-14 None of these reports could explain the mechanism or the clinical importance of phagocytosis by plasma cells. Here we report a myeloma pa- tient with phagocytic myeloma cells expressing CD15 on their surfaces. A 52-year-old female patient was admitted to our hospital with complaints of weakness and fatigue. Her medical history was unremarkable. Findings from a physical examination were normal, except that there was pallor. Laboratory findings were as follows: erythrocyte sedimentation rate was 120 mm/h; hemoglobin, 8.9 g/dL; white blood cell count, 3.8  10 9 /L; neutrophil count, 1.3  10 9 /L; and platelet count, 138  10 9 /L. Rouleaux formation was seen on peripheral blood smear. Blood urea nitrogen, uric acid, calcium, aspartate aminotransferase (AST), alanine amino- transferase (ALT), and lactate dehydrogenase levels were normal. Serum protein electrophoresis showed a monoclonal band (4.22 g/dL) in the gamma region. Serum immunoelectrophoresis revealed an abnormal immunoprecipitin with IgG-kappa specific- ity. Beta-2 microglobulin level was 6478 ng/mL (normal range, 1100-2300 ng/mL). Results of x-ray studies of the extremities, skull, ribs, pelvis, and long bones were normal. Bone marrow aspiration showed normal maturation of the granulocytic, erythrocytic, and megakaryocytic series. The myeloid/erythroid ratio was 2:1. Plasma cells represented 22% of the nucleated cells of bone marrow, and binucleated and atypical plasma cells were seen. In one-third of plasma cells, phagocytosis of mainly erythrocytes and platelets (and rarely, neutrophils, myelocytes, and lymphocytes) was seen (Figure 1). Diffuse plasma-cell infiltration with prominent kappa Figure 1. Phagocytic plasma cells. May-Gru ¨ nwald- Giemsa stain (original magnification  1000). 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