Association of CD117 and HLA‑DR expression with shorter overall survival and/or progression‑free survival in patients with multiple myeloma treated with bortezomib and thalidomide combination treatment without transplantation

Abstract

Certain immunophenotypes in multiple myeloma (MM), including CD56 and CD117, have been reported to be associated with overall survival (OS). However, previous reports have ignored the impact of different treatment regimens and the long-term prognostic value of immunophenotyping in MM when treated with novel agents, including thalidomide and bortezomib, in the absence of transplantation for autologous stem cell transplantation and allo-hematopoietic stem cell transplantation. To further understand the long-term prognostic value of immunophenotyping in MM, when treated with bortezomib combined with thalidomide-based regimens without transplantation, 80 patients who were newly diagnosed between January 2007 and December 2015, were analyzed retrospectively. In contrast to previous studies, no significant survival time difference was observed between CD56+/CD117+ and CD56-/CD117- groups. Multivariate analysis suggested that human leukocyte antigen-antigen D-related (HLA-DR)+ was independently associated with shorter OS and progression-free survival (PFS), while CD117+ was an independent prognostic factor for decreased PFS. In addition, the myeloma prognostic index (MPI), defined by HLA-DR+, age ≥65 years and international staging system stage III, was suitable for risk stratification of patients treated with novel agents for OS and PFS. The results of the current study suggested that HLA-DR+ patients had a shorter OS and PFS and CD117+ patients had shorter PFS. HLA-DR+ or CD117+ was sufficient to affect survival. Evaluating these markers may reveal valuable prognostic factors for MM in patients receiving bortezomib combined with thalidomide-based regimens without autologous stem cell transplantation and allo-hematopoietic stem cell transplantation). MPI may describe an accessible tool to predict the prognosis of patients with MM.

Evaluation of the UK Myeloma Research Alliance Risk Profile in Chinese Patients with Newly Diagnosed Multiple Myeloma without Autologous Stem Cell Transplantation

“…In addition, ISS was first proposed in 2003 and had a limited prognostic value in MM patients in the era of new drugs based on recent researches. 2 Similar with our previous published data, 16 ISS did not show significant prognostic value in these patients treated with bortezomib, while MRP still had a prognostic significance, which makes it necessary to study a new and simple scoring system such as MRP in the era of new drugs.…”

Detection of Measurable Residual Disease Biomarkers in Extracellular Vesicles from Liquid Biopsies of Multiple Myeloma Patients—A Proof of Concept

“…The HLA-DR antigen most frequently appears on the cytomembrane of macrophages and B lymphocytes and may aid the host immune system in identifying and attacking tumor cells. Its relation to MM is less explored but its persistence is associated with shorter survival [ 103 ]. Nonetheless, it was not possible to establish a pattern between these bad prognoses and our patients.…”

Therapeutic applications of the selective high affinity ligand drug SH7139 extend beyond non-Hodgkin’s lymphoma to many other types of solid cancers

“…Such responses have been reported to lead to systemic immunity [21] and better prognoses for patients with lymphoma [220], melanoma [221], colorectal [98,100,101,222], gastric [111], ovarian [63] and certain types of laryngeal [107], and breast [81, 223,224] cancers expressing HLA-DR than others diagnosed with same cancers that do not express HLA-DR. Tumors that do not express MHC class II proteins or have a deletion of the H2-DM gene which prevents the loading of antigenic peptides onto HLA-DRs containing CLIP [225] also appear to be better at escaping immunosurveillance [226][227][228][229][230] which has been suggested to lead to poorer tumor containment [228,[231][232][233], the outcome of which provides a worse prognosis for the patient [84,100,222,224,[233][234][235][236][237][238]. While some exceptions have been reported [88,[239][240][241], this has led to the suggestion that one approach for improving cancer therapy might be to force all cancer cells to become antigen presenting cells [219,226,242]. Should such an approach be implemented as a means to trigger the patient's immune system to mount a more effective antitumor response, it would also sensitize those tumors that do not normally express HLA-D...…”

“…The correlation between HLA-DR expression and more positive outcomes for patients has not, however, been observed for all types of cancer. HLA-DR expression by acute myelogenous leukemias [241], myelomas [240] and diffuse large B-cell lymphomas [237] have been reported to be highly predictive of poor patient survival. These reports, combined with the fact that a large fraction of so many different types of cancer express HLA-DRs, suggest the presence of tumor associated HLA-DRs may in some cases confer a benefit to the growth or survival of cancer cells.…”