Serial measurements of circulating plasma cells before and after induction therapy have an independent prognostic impact in patients with multiple myeloma undergoing upfront autologous transplantation

Circulating plasma cells at diagnosis, prior to auto-transplant and at relapse have a negative impact on survival in multiple myeloma. However, the impact of kinetics of circulating plasma cells along the course of illness has not been defined. We have analyzed 247 newly diagnosed multiple myeloma p...

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Bibliographic Details
Published in:Haematologica (Roma) 2017-08, Vol.102 (8), p.1439-1445
Main Authors: Chakraborty, Rajshekhar, Muchtar, Eli, Kumar, Shaji K, Jevremovic, Dragan, Buadi, Francis K, Dingli, David, Dispenzieri, Angela, Hayman, Suzanne R, Hogan, William J, Kapoor, Prashant, Lacy, Martha Q, Leung, Nelson, Gertz, Morie A
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Flow Cytometry
Humans
Induction Chemotherapy
Male
Middle Aged
Multiple Myeloma - diagnosis
Multiple Myeloma - pathology
Multiple Myeloma - therapy
Neoplastic Cells, Circulating - pathology
Plasma Cells - pathology
Prognosis
Transplantation, Autologous
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Summary:Circulating plasma cells at diagnosis, prior to auto-transplant and at relapse have a negative impact on survival in multiple myeloma. However, the impact of kinetics of circulating plasma cells along the course of illness has not been defined. We have analyzed 247 newly diagnosed multiple myeloma patients undergoing early auto-transplant who had paired evaluation of circulating plasma cells at diagnosis and pre-transplant by 6-color flow cytometry. A total of 117 patients had no detectable circulating plasma cells at both time points (CPC-/-), 82 had circulating plasma cells at diagnosis followed by complete eradication after induction (CPC+/-) and 48 had circulating plasma cells at transplant, including persistence of cells (CPC+/+; n=45) or emergence of new cells (CPC-/+; n=3) after induction. The rate of post-transplant stringent complete response was 32% in the CPC-/-, 30% in CPC+/- and 12% in CPC+/+ or -/+ groups ( =0.018). At a median follow up of 58 months from transplantation, the median progression-free survival in the 3 respective groups were 30, 24 and 14 months, and the 5-year overall survival rates were 83%, 70% and 43% (
ISSN:0390-6078
1592-8721
DOI:10.3324/haematol.2017.166629