Yao Weiqin, Yang Haifei, You Hongying, Shang Jingjing, Zhai Yingying, Yan Zhi, Yan Shuang, Shi Xiaolan, Yao Ying, Wang Jing, Wang Panfeng, Xu Yun, Jin Song, Yan Lingzhi, Wu Depei, Fu Chengcheng
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China.
Front Oncol. 2023 Sep 20;13:1266868. doi: 10.3389/fonc.2023.1266868. eCollection 2023.
Multiple myeloma (MM) is a highly characteristic tumor that is influenced by numerous factors that determine its prognosis. Studies indicate that the presence of circulating plasma cells (cPCs) is a detrimental factor that significantly impacts the prognosis of patients with MM.
This study retrospectively analyzed the prognostic value of cPCs quantified by 10-color flow cytometry in 145 newly diagnosed MM (NDMM) cases in the First Affiliated Hospital of Soochow University from November 2018 to February 2021. The study was approved by the Ethics Committee of the hospital (2021 No. 93).
Of the 145 patients, 99 (68.2%) were detected cPCs. Through receiver operating characteristics (ROC) analysis, an optimal threshold of 0.165% was identified as a predictor for overall survival (OS). The median progression-free survival (PFS) was 33 months in patients with cPCs ≥0.165%, whereas those with cPCs <0.165% had a PFS of <33 months (p=0.001). The median OS was not reached for two groups; the 3-year OS for patients with cPCs ≥0.165% was 71% compared with 87% for those with cPCs <0.165% (p=0.003). In transplant patients, cPCs ≥0.165% also predicted worse prognosis. Similarly, when considering cytogenetic risk factors in conjunction with cPC levels, comparable results were obtained. To evaluate whether the Revised International Staging System (R-ISS) groups could be further stratified based on different prognostic factors related to cPCs, our study revealed similar median PFS and OS rates in R-ISS II stage patients with cPCs ≥0.165% compared to those in the III stage (p=0.659 and 0.249, respectively).
This study demonstrates that a high ratio of cPCs serves as a reliable indicator for predicting a poorer prognosis in MM cases. Furthermore, incorporating the R-ISS system and cytogenetic risk factors alongside the level of cPCs enhances the accuracy of prognostic predictions for patients with MM.
多发性骨髓瘤（MM）是一种具有高度特征性的肿瘤，受多种决定其预后的因素影响。研究表明，循环浆细胞（cPCs）的存在是一个有害因素，会显著影响MM患者的预后。
本研究回顾性分析了2018年11月至2021年2月在苏州大学附属第一医院确诊的145例新发性MM（NDMM）病例中通过10色流式细胞术定量检测的cPCs的预后价值。该研究经医院伦理委员会批准（2021年第93号）。
145例患者中，99例（68.2%）检测到cPCs。通过受试者工作特征（ROC）分析，确定最佳阈值为0.165%作为总生存期（OS）的预测指标。cPCs≥0.165%的患者中位无进展生存期（PFS）为33个月，而cPCs<0.165%的患者PFS<33个月（p=0.001）。两组的中位OS均未达到；cPCs≥0.165%的患者3年OS为71%，而cPCs<0.165%的患者为87%（p=0.003）。在移植患者中，cPCs≥0.165%也预示着更差的预后。同样，当结合细胞遗传学危险因素和cPC水平时，也得到了类似的结果。为了评估修订后的国际分期系统（R-ISS）组是否可以根据与cPCs相关的不同预后因素进一步分层，我们的研究显示，cPCs≥0.165%的R-ISS II期患者与III期患者的中位PFS和OS率相似（分别为p=0.659和0.249）。
本研究表明，高比例的cPCs是预测MM病例预后较差的可靠指标。此外，将R-ISS系统和细胞遗传学危险因素与cPCs水平相结合，可提高MM患者预后预测的准确性。
