Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.
West China School of Medicine, Sichuan University, Chengdu, China.
Front Immunol. 2021 Aug 19;12:671904. doi: 10.3389/fimmu.2021.671904. eCollection 2021.
To assess patients with multiple myeloma (MM), the whole-body positron-emission tomography/computed tomography (PET/CT) occupies a pivotal position for diagnostic stratification, response evaluation, and survival prediction, while important limitations are recognized as incapable of representing tumor microenvironment. Regulatory B cells (Bregs) have been reported to have an inhibitory immune function, contributing to bone marrow (BM)-immunosuppressive microenvironment for MM. Therefore, to investigate the role of PET/CT in combination with Bregs' ratios to predict therapeutic response and survival, we sequentially enrolled 120 patients with newly diagnosed MM (NDMM) who were treated with novel agents in our center, while conventional PET/CT parameters including maximum standard uptake value (SUVmax), ratios of BM-derived Bregs within CD19 B cells, and patients' clinical characteristics were collected. After a median follow-up of 28.20 months (range 7.00-46.93 months), SUVmax > 4.2 at onset, accounting for 53.2% of NDMM, was uncovered to predict inferior progression-free survival (PFS) as well as overall survival (OS). With regard to the ratios of BM-derived Bregs within CD19 B cells, the cohort with the Bregs' proportions lower than 10%, accounting for 46.2%, exerted poorer OS. Additionally, the patients with both SUVmax > 4.2 and Bregs' ratios < 10%, accounting for 31.7%, yielded compromised therapeutic response and long-term survival. Collectively, this study may draw attention on the prognostic value of combination of PET/CT and Bregs' ratios when clinical decisions are made for MM in the era of novel agents.
为了评估多发性骨髓瘤（MM）患者，全身正电子发射断层扫描/计算机断层扫描（PET/CT）在诊断分层、反应评估和生存预测方面占据关键地位，而其重要局限性在于无法代表肿瘤微环境。调节性 B 细胞（Bregs）已被报道具有抑制性免疫功能，有助于 MM 的骨髓（BM）免疫抑制微环境。因此，为了研究 PET/CT 与 Bregs 比值结合预测治疗反应和生存的作用，我们连续入组了 120 名在我们中心接受新型药物治疗的初诊 MM（NDMM）患者，同时收集了常规 PET/CT 参数，包括最大标准摄取值（SUVmax）、CD19 B 细胞内 BM 来源 Bregs 的比值以及患者的临床特征。在中位随访 28.20 个月（范围 7.00-46.93 个月）后，发现 SUVmax 在发病时＞4.2，占 NDMM 的 53.2%，可预测较差的无进展生存（PFS）和总生存（OS）。就 CD19 B 细胞内 BM 来源 Bregs 的比值而言，比例低于 10%的患者占 46.2%，OS 更差。此外，同时具有 SUVmax＞4.2 和 Bregs 比值＜10%的患者占 31.7%，治疗反应和长期生存均较差。总的来说，这项研究可能会引起人们对在新型药物时代进行 MM 临床决策时 PET/CT 与 Bregs 比值联合应用的预后价值的关注。
