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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
[Prognostic value of circulating plasma cell in newly diagnosed multiple myeloma treated with bortezomib,
1Department of Hematology, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Abstract:
Objective: To investigate the prognostic value of circulating plasma cell (CPC) in patients with newly diagnosed multiple myeloma (NDMM) undergoing induction therapy with bortezomib, lenalidomide, and dexamethasone (VRD) regimen. Methods: This study retrospectively analyzed clinical data of 152 patients with NDMM treated with the VRD regimen as induction therapy in the Hematology Department of Jiangsu Provincial People's Hospital from January 2019 to March 2024. The clinical characteristics, efficacy, and prognosis of patients with high and low CPC proportions are compared. The prognosis of patients in the CPC-positive group, CPC-negative conversion group, and CPC-negative group was analyzed. Results: This study included 152 patients with NDMM, comprising 76 males and 76 females, with a median age at onset of 62 (40-77) years. Compared with the group with CPC proportion of <0.105%, patients with CPC proportion of ≥0.105% demonstrated a higher proportion of International Staging System (ISS) stage Ⅲ (P<0.001), Revised ISS stage Ⅲ (P=0.023), HGB≤100 g/L (P=0.015), β(2)-microglobulin ≥3.5 g/L (P<0.001), shorter median progression-free survival (PFS) period (24 months vs 52 months, P<0.001), and shorter median overall survival (OS) period (52 months vs not achieved, P=0.005). Patients in the CPC-negative group demonstrated a longer median PFS period (not reached vs 41 months vs 19 months, P<0.001) and median OS period (not reached vs not reached vs 26 months, P<0.001) compared with patients in the CPC-negative conversion group and CPC-positive group. Multivariate analysis revealed CPC proportion of ≥0.105% (HR=3.79, 95% CI: 1.95-7.38, P<0.001), positive CPC after induction therapy (HR=3.54, 95% CI: 1.41-8.87, P=0.007), and cytogenetic high risk (HR=3.69, 95% CI: 1.85-7.37, P<0.001) as independent risk factors affecting the PFS of patients. Meanwhile, CPC of ≥0.105% (HR=3.50, 95% CI: 1.29-9.48, P=0.014) and positive CPC after induction therapy (HR=4.12, 95% CI: 1.13-15.03, P=0.032) are independent risk factors affecting the OS of patients. Conclusion: Patients with NDMM demonstrating high CPC expression have a worse prognosis, with CPC level as an independent prognostic factor.
