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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

Authors :
Rajshekhar Chakraborty
Eli Muchtar
Shaji K. Kumar
Dragan Jevremovic
Francis K. Buadi
David Dingli
Angela Dispenzieri
Suzanne R. Hayman
William J. Hogan
Prashant Kapoor
Martha Q. Lacy
Nelson Leung
Morie A. Gertz
Source :
Haematologica, Vol 102, Iss 8 (2017)
Publication Year :
2017
Publisher :
Ferrata Storti Foundation, 2017.

Abstract

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 (P=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% (P

Details

Language :
English
ISSN :
03906078 and 15928721
Volume :
102
Issue :
8
Database :
Directory of Open Access Journals
Journal :
Haematologica
Publication Type :
Academic Journal
Accession number :
edsdoj.5b2b9089e2c14cfd9cbcb02fa4fd9257
Document Type :
article
Full Text :
https://doi.org/10.3324/haematol.2017.166629