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High FCRL5 expression predicts poor treatment response and survival in newly diagnosed multiple myeloma: a
Cainan Yu1, Minghua Zhang1, Jie Hui1
1Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Objectives:
Limited research is currently available regarding the prognostic value of Fc receptor-like 5 (FCRL5) in newly diagnosed multiple myeloma (NDMM). This study aimed to investigate the association of FCRL5 expression with treatment response and survival outcomes in NDMM patients, with a goal of providing insights for early risk stratification.
Methods:
We retrospectively analyzed a cohort comprising 54 NDMM patients treated between January 2024 and January 2025 at a single center. Pretreatment FCRL5 expression was quantified by flow cytometry, and the median value (75.15%) was utilized to stratify patients into two groups: high expression group and low expression group for comparison of baseline characteristics, treatment response, and survival outcomes.
Results:
Baseline characteristics, including age and disease stage, were balanced between the two FCRL5 expression groups, with all P-values > 0.05. After four induction cycles, the group with high FCRL5 expression showed substantially lower rates of complete response (25.93% vs. 51.85%), ≥very good partial response (33.33% vs. 70.37%), and minimal residual disease negativity (29.63% vs. 70.37%) (P < 0.05 for all). At 10.3-month median follow-up, the median progression-free survival (PFS) (10.6 months in contrast to not reached, P = 0.002) and overall survival (OS) (13.2 months as opposed to not reached, P = 0.02), as well as 1-year PFS rate (21.43% vs. 76.47%, P = 0.004) were markedly shorter. Multivariate regression analysis confirmed high FCRL5 expression as an independent adverse prognostic factor for both PFS (HR 7.32, 95% CI 1.86 - 28.74, P = 0.004) and OS (HR 9.82, 95% CI 1.01 - 95.10, P = 0.049).
Conclusion:
High FCRL5 expression was significantly associated with inferior response depth and survival in NDMM. Our findings suggested that FCRL5 may serve as a valuable biomarker for risk stratification, though further prospective validation is required.
