Journal
LEUKEMIA
Volume 31, Issue 1, Pages 130-135Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/leu.2016.205
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Funding
- Mayo Clinic Hematological Malignancies Program
- National Cancer Institute, Rockville, MD, USA [CA107476, CA62242, CA100707, CA168762, CA83724]
- Jabbs Foundation, Birmingham, UK
- Henry J. Predolin Foundation, USA
- CTSA from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [UL1 TR000135]
- Marion Schwarz Foundation
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The presence of high numbers of circulating clonal plasma cells (cPCs) in patients with smoldering multiple myeloma (SMM), detected by a slide-based immunofluorescence assay, has been associated with a shorter time to progression (TTP) to MM. The significance of quantifying cPCs via multiparameter flow cytometry, a much more readily available diagnostic modality, in patients with SMM has not been evaluated. This study evaluated 100 patients with a known or new diagnosis of SMM who were seen at the Mayo Clinic, Rochester from January 2008 until December 2013. Patients with >= 150 cPCs (N=9) were considered to have high number of cPCs based on the 97% specificity and 78% PPV of progression to MM within 2 years of cPC assessment. The median TTP of patients with >= 150 cPCs was 9 months compared with not reached for patients with <150 cPCs (P<0.001). Thus, quantification of cPCs via multiparametric flow cytometry identifies patients with SMM at very high risk of progression to MM within 2 years and warrants confirmation in larger studies. In the future, this may allow reclassification of such patients as having MM requiring therapy prior to them enduring end-organ damage.
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