Reduced CXCR4 expression in associated with extramedullary and predicts poor survival in newly diagnosed multiple myeloma

Expert Rev Hematol. 2022 Nov;15(11):1017-1021. doi: 10.1080/17474086.2022.2113772. Epub 2022 Aug 17.

Abstract

Background: Multiple myeloma (MM), a bone marrow-resident hematological malignancy of plasma cells, has remained largely incurable despite the recent advancement in novel therapies. The heterogeneity of myeloma cells makes risk stratification of MM important for therapeutic regimen planning.

Research design and methods: No immunohistochemical (IHC) predictive and prognostic marker of MM has been constructed yet. Herein, the prognostic value of chemokine (C-X-C motif) receptor 4 (CXCR4) expression in 48 newly diagnosed MM patients was explored using IHC. Correlations between CXCR4 expression and clinical features of MM were analyzed.

Results: CXCR4-positive patients significantly outperformed CXCR4-negative patients in both 3-year estimated overall survival (93.8% vs 45.8%, P = 0.0392) and progression-free survival (57.1% vs 40.9%, P = 0.0436).

Conclusions: The incidence of extramedullary lesions in CXCR4-negative patients increased significantly compared with CXCR4-positive patients. Plasma cells that reduce CXCR4 expression have poor prognosis and increase the incidence of extramedullary lesions.

Keywords: CXCR4; Multiple myeloma; extramedullary lesions; new diagnosis; prognostic biomarker.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / genetics
  • Multiple Myeloma* / therapy
  • Progression-Free Survival
  • Receptors, CXCR4 / genetics

Substances

  • CXCR4 protein, human
  • Receptors, CXCR4