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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 impact of immunophenotypic complete response in patients with multiple myeloma achieving better than
Kota Fukumoto1, Manabu Fujisawa1, Yasuto Suehara1
1a Division of Hematology/Oncology, Department of Internal Medicine , Kameda Medical Center , Chiba , Japan.
Insights
Achieving immunophenotypic complete response (iCR) in multiple myeloma (MM) significantly improves disease-free survival. Pursuing iCR is crucial, even for patients who attain stringent complete response (sCR).
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Multiple myeloma (MM) is a hematologic malignancy.
- Assessing depth of response is crucial for predicting patient outcomes.
- Current response criteria may not fully capture prognostic information.
Purpose of the Study:
- To evaluate the impact of immunophenotypic complete response (iCR) on survival in MM patients.
- To compare the prognostic value of iCR versus stringent complete response (sCR).
Main Methods:
- Retrospective analysis of 78 MM patients achieving conventional CR.
- Utilized multicolor flow cytometry (MFC) to define iCR (≤10⁻⁴ MM cells).
- Survival outcomes (DFS, OS) were landmarked at CR achievement.
Main Results:
- iCR rates were 44% in CR patients and 49% in sCR patients.
- iCR achievement significantly improved DFS in both CR (p=0.009) and sCR (p=0.002) cohorts.
- sCR alone did not significantly impact DFS or OS (p>0.05).
- Multivariate analysis identified iCR as an independent predictor of longer 2-year DFS.
Conclusions:
- iCR is a significant predictor of improved disease-free survival in MM.
- The pursuit of iCR is important for optimizing patient management, even in those achieving sCR.
- iCR offers valuable prognostic information beyond conventional response assessments.
Abstract:
To investigate the impact of immunophenotypic complete response [iCR, ≤10(-4) multiple myeloma (MM) cells defined by multicolor flow cytometry (MFC)] on survival in patients with MM, we retrospectively analyzed 78 patients that obtained conventional CR at our hospital. Survivals were landmarked at achievement of CR. The rate of stringent CR (sCR) among patients with CR was 88%, and iCR for CR and sCR patients were 44% and 49%, respectively. Achievement of iCR was associated with significantly longer disease-free survival (DFS) not only in CR patients (p = 0.009) but also in sCR patients (p = 0.002), while sCR attainment per se did not have statistically significant impact on DFS (p = 0.06) or overall survival (OS) (p = 0.587). Univariate and multivariate analyses indicated that attainment of iCR was independently associated with longer 2-year DFS in addition to creatinine (≤2.0 mg/dL) and maintenance therapy. This study highlights the importance of pursuing iCR even in patients with sCR.
