The prognostic significance of circulating plasma cells in newly diagnosed multiple myeloma patients

Weiqin Yao; Haifei Yang; Hongying You; Jingjing Shang; Yingying Zhai; Zhi Yan; Shuang Yan; Xiaolan Shi; Ying Yao; Jing Wang; Panfeng Wang; Yun Xu; Song Jin; Lingzhi Yan; Depei Wu; Chengcheng Fu

doi:10.3389/fonc.2023.1266868

The prognostic significance of circulating plasma cells in newly diagnosed multiple myeloma patients

Front Oncol. 2023 Sep 20:13:1266868. doi: 10.3389/fonc.2023.1266868. eCollection 2023.

Authors

Weiqin Yao^{1

2}, Haifei Yang^{1

2}, Hongying You^{1

2}, Jingjing Shang^{1

2}, Yingying Zhai^{1

2}, Zhi Yan^{1

2}, Shuang Yan^{1

2}, Xiaolan Shi^{1

2}, Ying Yao³, Jing Wang³, Panfeng Wang³, Yun Xu³, Song Jin^{1

2}, Lingzhi Yan^{1

2}, Depei Wu^{1

2}, Chengcheng Fu^{1

2}

Affiliations

¹ National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
² Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China.
³ Suzhou Hongci, Hematology Hospital, The First Affiliated Hospital of Soochow University, Suzhou, China.

Abstract

Objective: 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.

Methods: 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).

Results: 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).

Conclusion: 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.

Keywords: circulating plasma cells; cytogenetic risk factors; flow cytometry; multiple myeloma; prognosis.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Translational Research Grant of NCRCH (Grant No. 2020ZKPB01), Suzhou Project of Science and Technology 2021 (Grant No. SLJ2021004), and the China Primary Health Care Foundation.