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Enhancing the R-ISS classification of newly diagnosed multiple myeloma by quantifying circulating clonal plasma cells.

ABSTRACT: Our prior studies identified the prognostic significance of quantifying cPCs by multiparametric flow cytometry (MFC) in newly diagnosed multiple myeloma (NDMM) patients. We evaluated if a similar quantification of cPCs could add prognostic value to the current R-ISS classification of 556 consecutive NDMM patients seen at the Mayo Clinic, Rochester from 2009 to 2017. Those patients that had ?5 cPCs/?L and either R-ISS stage I or stage II disease were re-classified as R-ISS IIB stage for the purposes of this study. The median time to next therapy (TTNT) and overall survival (OS) for patients with ?5 cPCs/?L at diagnosis was as follows: R-ISS I (N = 110) - 40?months and not reached; R-ISS II (N = 69) - 30 and 72?months; R-ISS IIB (N = 96) - 21 and 45?months and R-ISS III (N = 281) - 20 and 47?months respectively. Finally, ??5 cPCs/?L retained its adverse prognostic significance in a multivariable model for TTNT and OS. Hence, quantifying cPCs by MFC can potentially enhance the R-ISS classification of a subset of NDMM patients with stage I and II disease by identifying those patients with a worse than expected survival outcome.

SUBMITTER: Gonsalves WI

PROVIDER: S-EPMC7724649 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Enhancing the R-ISS classification of newly diagnosed multiple myeloma by quantifying circulating clonal plasma cells.

Gonsalves Wilson I WI Jevremovic Dragan D Nandakumar Bharat B Dispenzieri Angela A Buadi Francis K FK Dingli David D Lacy Martha Q MQ Hayman Suzanne R SR Kapoor Prashant P Leung Nelson N Fonder Amie A Hobbs Miriam M Hwa Yi Lisa YL Muchtar Eli E Warsame Rahma R Kourelis Taxiarchis V TV Russell Stephen S Lust John A JA Lin Yi Y Go Ronald S RS Siddiqui Mustaqeem A MA Kyle Robert A RA Gertz Morie A MA Rajkumar S Vincent SV Kumar Shaji K SK

American journal of hematology 20200108 3

Our prior studies identified the prognostic significance of quantifying cPCs by multiparametric flow cytometry (MFC) in newly diagnosed multiple myeloma (NDMM) patients. We evaluated if a similar quantification of cPCs could add prognostic value to the current R-ISS classification of 556 consecutive NDMM patients seen at the Mayo Clinic, Rochester from 2009 to 2017. Those patients that had ≥5 cPCs/μL and either R-ISS stage I or stage II disease were re-classified as R-ISS IIB stage for the purpo ...[more]

PMID: 31867775

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Project description:ObjectivesMultiple myeloma (MM) is a malignant plasma cell disorder. The most widely accepted staging system for MM is the revised International Staging System based on cytogenetic and clinical biomarkers. The circulating clonal plasma cells (CPCs) were reported to have potential prognostic impact on MM. Among various diagnostic approaches, multiparametric flow cytometry (FCM) offers heightened sensitivity, minimal invasiveness and reproducibility. We conducted a meta-analysis to evaluate the prognostic value of quantifying CPCs via FCM in newly diagnosed symptomatic MM (NDMM) patients.DesignSystematic review and meta-analysis.Data sourcePubMed, Web of Science, Embase and references of included studies.Eligibility criteria for selecting studiesWe included observational studies that evaluated the prognostic value of CPCs detected by FCM in NDMM.Data extraction and synthesisData were screened and extracted independently by two investigators. The pooled results originated from random effects models. The primary endpoint was overall survival (OS). The secondary endpoint was progression-free survival (PFS). To evaluate the prognostic value of CPCs in NDMM, HRs and their 95% CI for both OS and PFS were derived using COX multivariable models. These values were then used to compute the pooled estimated effect.ResultsOur meta-analysis encompassed a total of 2704 NDMM patients from 11 studies up to 27 August 2022. The pooled HR for OS and PFS in CPC-positive (CPCs+) group and CPC-negative group were 1.95 (95% CI 1.24 to 3.07) and 2.07 (95% CI 1.79 to 2.39), respectively. The autologous stem cell transplantation (ASCT) failed to eliminate the adverse impact on OS and PFS. The heterogeneity may stem from the use of novel agents or traditional chemotherapy as initial treatment.ConclusionThis meta-analysis indicates CPCs+ had an adverse impact on the prognosis of NDMM patients in the total population, and the adverse impact could not be eliminated by ASCT.Prospero registration numberCRD42021272381.

Dataset Information

Enhancing the R-ISS classification of newly diagnosed multiple myeloma by quantifying circulating clonal plasma cells.

Publications

Enhancing the R-ISS classification of newly diagnosed multiple myeloma by quantifying circulating clonal plasma cells.

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