4.6 Article

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

期刊

AMERICAN JOURNAL OF HEMATOLOGY
卷 95, 期 3, 页码 310-315

出版社

WILEY
DOI: 10.1002/ajh.25709

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资金

  1. Mayo Clinic Hematological Malignancies Program
  2. National Cancer Institute of the National Institutes of Health [K23CA218742, P50CA186781]
  3. Marion Schwartz Foundation

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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/mu 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/mu 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/mu 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.

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