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Plasma cell proliferative index is an independent predictor of progression in smoldering multiple myeloma

Mohammed A Aljama1, M Hasib Sidiqi1, Arjun Lakshman1

  • 1Division of Hematology and.

Blood Advances
|November 23, 2018
PubMed

Insights

The plasma cell proliferative index (PCPI) helps predict disease progression in smoldering multiple myeloma. An elevated PCPI indicates a higher risk of earlier progression, aiding in patient risk stratification.

Area of Science:

  • Hematology
  • Oncology
  • Cell Biology

Background:

  • The plasma cell proliferative index (PCPI) measures S-phase cells, offering prognostic value in plasma cell disorders.
  • Multiple myeloma and amyloidosis are significant plasma cell disorders where prognosis is crucial.

Purpose of the Study:

  • To evaluate the prognostic significance of PCPI in patients with smoldering multiple myeloma (SMM).
  • To determine if PCPI can identify SMM patients at higher risk for disease progression.

Main Methods:

  • Retrospective review of 306 patients diagnosed with smoldering multiple myeloma.
  • Analysis of plasma cell proliferative index (PCPI) levels, categorized as elevated (>0.5) or low.
  • Comparison of time to progression and progression rates between patients with elevated and low PCPI.

Main Results:

  • Twenty-six percent (79/306) of patients had an elevated PCPI.
  • An elevated PCPI was associated with a significantly shorter time to progression (median 3.0 years vs. 7.1 years; P = .0004).
  • Patients with elevated PCPI showed a higher progression rate within 24 months (49% vs. 20%; P < .0001).

Conclusions:

  • PCPI is a valuable prognostic tool for risk stratifying patients with smoldering multiple myeloma.
  • Elevated PCPI identifies patients likely to experience earlier progression, suggesting a need for closer monitoring.
  • These findings support considering early intervention trials for SMM patients with an elevated PCPI.

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