Clinical implications of residual normal plasma cells within bone marrow across various disease stages in multiple myeloma

• Published in: Leukemia 2024-10, Vol.38 (10), p.2235-2245
• Main Authors: Yan, Wenqiang, Shi, Lihui, Xu, Jingyu, Li, Lingna, Cui, Jian, Liu, Yuntong, Zhou, Jieqiong, Du, Chenxing, Yu, Tengteng, Zhang, Shuaishuai, Lv, Rui, Sui, Weiwei, Deng, Shuhui, Li, Xiaoqing, Du, Xin, Xu, Yan, Zou, Dehui, Qiu, Lugui, Hao, Mu, An, Gang
• Format: Article
• Language: English
• Subjects: 13/31; 14/32; 631/67/1990/804; 692/499; 82/80; Biomarkers; Bone marrow; Cancer Research; Critical Care Medicine; Cytogenetics; Hematology; Immune reconstitution; Intensive; Internal Medicine; Medicine; Medicine & Public Health; Minimal residual disease; Multiple myeloma; Oncology; Plasma cells; Risk; Tumors
• ISSN: 0887-6924; 1476-5551; 1476-5551
• DOI: 10.1038/s41375-024-02366-9

Residual normal plasma cells (NPCs), which compete with tumor plasma cells, play an important role in multiple myeloma. However, large-scale cohort studies investigating residual NPCs, especially at the minimal residual disease (MRD) phase, are currently lacking. In this study, we conducted a comprehensive investigation into the clinical significance of residual NPCs throughout the entire disease course in 1363 myeloma patients from the NICHE cohort (NCT04645199). Our results revealed that myeloma patients with high baseline NPCs ratio (≥5%) exhibited distinct indolent features, characterized by lower tumor burden, reduced frequencies of cytopenia, immunoparesis, and high-risk cytogenetics. Importantly, high residual NPCs ratio at diagnosis or relapse was independently associated with favorable survival. High absolute percentages of NPCs at undetectable MRD were related with superior clinical benefit and immune reconstitution. At MRD-positive phases, grouping based on NPCs ratio (