Ghosh Toshi, Gonsalves Wilson I, Jevremovic Dragan, Dispenzieri Angela, Dingli David, Timm Michael M, Morice William G, Kapoor Prashant, Kourelis Taxiarchis V, Lacy Martha Q, Hayman Suzanne R, Buadi Francis K, Leung Nelson, Go Ronald S, Lin Yi, Russell Stephen J, Lust John A, Zeldenrust Steven R, Warsame Rahma, Hwa Yi L, Kyle Robert A, Gertz Morie A, Vincent Rajkumar S, Kumar Shaji K
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
Division of Hematology, Mayo Clinic, Rochester, Minnesota.
Am J Hematol. 2017 Sep;92(9):E507-E512. doi: 10.1002/ajh.24807. Epub 2017 Jul 19.
Prior studies have revealed that the presence of increasing number of polyclonal plasma cells (pPCs) in the bone marrow (BM) are associated with better outcomes in newly diagnosed multiple myeloma (MM) patients. This effect has not been studied in patients with MM at the time of disease relapse. We determined the prognostic value of depletion of pPCs in the BM by 7-color multiparameter flow cytometry in a series of 174 relapsing MM patients. The time to next therapy (TTNT) in those with <5% pPCs was 9.4 months versus 13.9 months in those with ≥5% pPCs (P = .0091). The median overall survival (OS) in those with <5% pPCs was 21.4 months, while the median OS was not reached in those patients with ≥5% pPCs (P = .019). Of the 109 patients with standard risk cytogenetics, the median OS of those with <5% pPCs was 28.4 months, while the median OS was not reached in those with ≥5% pPCs (P = .033). As such, <5% pPCs in the BM appears to have prognostic utility in identifying a subset of relapsing MM patients, even with standard-risk cytogenetics, who have a particularly adverse outcome.
先前的研究表明，骨髓（BM）中多克隆浆细胞（pPCs）数量的增加与新诊断的多发性骨髓瘤（MM）患者更好的预后相关。尚未在疾病复发时的MM患者中研究这种效应。我们通过7色多参数流式细胞术确定了174例复发MM患者骨髓中pPCs耗竭的预后价值。pPCs<5%的患者下次治疗时间（TTNT）为9.4个月，而pPCs≥5%的患者为13.9个月（P = 0.0091）。pPCs<5%的患者中位总生存期（OS）为21.4个月，而pPCs≥5%的患者未达到中位OS（P = 0.019）。在109例具有标准风险细胞遗传学的患者中，pPCs<5%的患者中位OS为28.4个月，而pPCs≥5%的患者未达到中位OS（P = 0.033）。因此，骨髓中pPCs<5%似乎在识别复发MM患者的一个亚组方面具有预后价值，即使是具有标准风险细胞遗传学的患者，其预后也特别差。
