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Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients
Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156676/ https://www.ncbi.nlm.nih.gov/pubmed/37137874 http://dx.doi.org/10.1038/s41408-023-00842-6 |
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author | Pasvolsky, Oren Milton, Denái R. Rauf, Mikael Ghanem, Sassine Masood, Adeel Mohamedi, Ali H. Tanner, Mark R. Bashir, Qaiser Srour, Samer Saini, Neeraj Lin, Paul Ramdial, Jeremy Nieto, Yago Tang, Guilin Lee, Hans C. Patel, Krina K. Kebriaei, Partow Thomas, Sheeba K. Weber, Donna M. Orlowski, Robert Z. Rezvani, Katy Champlin, Richard Shpall, Elizabeth J. Lin, Pei Qazilbash, Muzaffar H. |
author_facet | Pasvolsky, Oren Milton, Denái R. Rauf, Mikael Ghanem, Sassine Masood, Adeel Mohamedi, Ali H. Tanner, Mark R. Bashir, Qaiser Srour, Samer Saini, Neeraj Lin, Paul Ramdial, Jeremy Nieto, Yago Tang, Guilin Lee, Hans C. Patel, Krina K. Kebriaei, Partow Thomas, Sheeba K. Weber, Donna M. Orlowski, Robert Z. Rezvani, Katy Champlin, Richard Shpall, Elizabeth J. Lin, Pei Qazilbash, Muzaffar H. |
author_sort | Pasvolsky, Oren |
collection | PubMed |
description | Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS. |
format | Online Article Text |
id | pubmed-10156676 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-101566762023-05-05 Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients Pasvolsky, Oren Milton, Denái R. Rauf, Mikael Ghanem, Sassine Masood, Adeel Mohamedi, Ali H. Tanner, Mark R. Bashir, Qaiser Srour, Samer Saini, Neeraj Lin, Paul Ramdial, Jeremy Nieto, Yago Tang, Guilin Lee, Hans C. Patel, Krina K. Kebriaei, Partow Thomas, Sheeba K. Weber, Donna M. Orlowski, Robert Z. Rezvani, Katy Champlin, Richard Shpall, Elizabeth J. Lin, Pei Qazilbash, Muzaffar H. Blood Cancer J Article Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS. Nature Publishing Group UK 2023-05-03 /pmc/articles/PMC10156676/ /pubmed/37137874 http://dx.doi.org/10.1038/s41408-023-00842-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Pasvolsky, Oren Milton, Denái R. Rauf, Mikael Ghanem, Sassine Masood, Adeel Mohamedi, Ali H. Tanner, Mark R. Bashir, Qaiser Srour, Samer Saini, Neeraj Lin, Paul Ramdial, Jeremy Nieto, Yago Tang, Guilin Lee, Hans C. Patel, Krina K. Kebriaei, Partow Thomas, Sheeba K. Weber, Donna M. Orlowski, Robert Z. Rezvani, Katy Champlin, Richard Shpall, Elizabeth J. Lin, Pei Qazilbash, Muzaffar H. Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title | Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title_full | Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title_fullStr | Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title_full_unstemmed | Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title_short | Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
title_sort | impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156676/ https://www.ncbi.nlm.nih.gov/pubmed/37137874 http://dx.doi.org/10.1038/s41408-023-00842-6 |
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