Zou Zhongqing, Guo Tingting, Cui Jian, Tang Wenjiao, Li Yan, Wang Fangfang, Dong Tian, Yang Yunfan, Feng Yan, Ho Matthew, Zhang Li, Pan Ling, Niu Ting
Department of Hematology, West China Hospital, Sichuan University, China.
Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
J Cancer. 2021 Mar 5;12(9):2633-2642. doi: 10.7150/jca.53209. eCollection 2021.
Multiple myeloma (MM) is a heterogeneous disease that remains incurable with significant interpatient variability in outcomes. Regulatory B cells (Bregs) were observed to be involved into specific defects in MM. Here, we provide our risk-adapted approach to newly diagnosed MM (NDMM), combining with the fundamental dysfunction of Bregs. We reported one hundred consecutive patients with NDMM from South-Western China, primarily treated with bortezomib plus dexamethasone with or without a 3 agent, were enrolled from 2017. Bone marrow aspirates were obtained and flow cytometry (FCM) was used to quantify the percentage of Bregs from the bone marrow. The correlation between Bregs and clinical characters were further analyzed. This study found using bortezomib plus dexamethasone as backbone showed promising efficacy with acceptable tolerability in NDMM. The relatively compromised progression free survival (PFS) points to the essential synergy of bortezomib and lenalidomide here. This study also found that altered proportions of Bregs were closely correlated with treatment efficacy and prognosis in MM. Further understanding of Bregs biology might provide new opportunities to develop immunotherapy, which could prove beneficial in treating MM.
多发性骨髓瘤(MM)是一种异质性疾病,目前仍无法治愈,患者间的预后存在显著差异。研究发现调节性B细胞(Bregs)与MM的特定缺陷有关。在此,我们结合Bregs的基本功能障碍,提出了针对新诊断多发性骨髓瘤(NDMM)的风险适应性治疗方法。我们报告了来自中国西南部的100例连续的NDMM患者,这些患者主要接受硼替佐米联合地塞米松治疗,部分患者联合第三种药物,研究对象选取自2017年。采集骨髓穿刺样本,采用流式细胞术(FCM)定量骨髓中Bregs的百分比。进一步分析Bregs与临床特征之间的相关性。本研究发现,以硼替佐米联合地塞米松为基础的治疗方案在NDMM中显示出有前景的疗效和可接受的耐受性。相对较差的无进展生存期(PFS)表明硼替佐米和来那度胺在此处具有重要的协同作用。本研究还发现,Bregs比例的改变与MM的治疗疗效和预后密切相关。进一步了解Bregs生物学特性可能为开发免疫疗法提供新机会,这可能对MM治疗有益。