Prognostic value of circulating clonal plasma cells in newly diagnosed multiple myeloma

Abstract

Objectives: Multiple myeloma (MM) involves a clinically and biologically heterogeneous malignancy of plasma cells. It is difficult to predict the prognosis of MM. The presence of circulating clonal plasma cells (CPC) has been associated with a worse prognosis in patients with MM. Methods: This study retrospectively analysed CPC in 108 newly diagnosed MM patients by 8colour flow cytometry to investigate their value for predicting the outcome and combined the level of CPC with the revised International Staging System (R-ISS) to stratify the MM patients according to risk. Results: CPC were detected in 58/108 patients (53.7%). The optimum cut-off for the prediction of overall survival was determined to be 0.105%. Patients with higher R-ISS stages seemed to harbour more CPC. A level of CPC≥0.105% was an independent risk factor for adverse outcomes (P<0.001). The combination of the R-ISS staging system and level of CPC was used to stratify MM patients according to risk, and the combination of R-ISS stage III and a level of CPC≥0.105% defined the ultra-high-risk group. Conclusion:This study suggests that a high proportion of CPC is associated with aggressive disease and that the use of the current R-ISS system in conjunction with assessment of the level of CPC may facilitate the stratification of newly diagnosed MM patients into clinically relevant prognostic subgroups.

Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy

“…Several authors have demonstrated that the presence of circulating plasma cells in peripheral blood is a prognostic biomarker that could be used for risk stratification in MM [32][33][34][35][36]. We, therefore, wanted to analyze this parameter in our series, in the context of anti-CD38 therapy.…”

High-risk multiple myeloma predicted by circulating plasma cells and its genetic characteristics

“…Samples of blood or BM were stained with antibodies to CD19, CD27, CD38, CD45, CD56, CD138, cLambda and cKappa, and cells were subsequently detected by 8-color flow cytometry to quantify CPC and BMPC. Details of the flow cytometry technique for CPC and BMPC detection have been described in our previous studies ( 20 , 21 ).…”

Liquid biopsy by analysis of circulating myeloma cells and cell-free nucleic acids: a novel noninvasive approach of disease evaluation in multiple myeloma

“…Chromosomal abnormalities (CAs) play a significant role for predicting the risk of patients with MM. CMMC levels were correlated with a higher incidence of high-risk cytogenetic abnormalities [6,13,20,27,28,34,63,[70][71][72], a lower incidence of hyperdiploidy [26], and standard-risk cytogenetic abnormalities [34]. CMMC abundance was associated with disease burden in the BM, including the tumor cell involvement [6, 7, 13, 14, 20, 23-25, 28, 33, 34, 39, 63, 70, 71] and the myeloma clone levels of Ig rearrangements in the BM [44].…”