The persistence of immunophenotypically normal residual bone marrow plasma cells at diagnosis identifies a good prognostic subgroup of symptomatic multiple myeloma patients
Por:
Paiva, B, Vidriales, MB, Mateo, G, Perez, JJ, Montalban, MA, Sureda, A, Montejano, L, Gutierrez, NC, de Coca, AG, de las Heras, N, Mateos, MV, Lopez-Berges, MC, Garcia-Boyero, R, Galende, J, Hernandez, J, Palomera, L, Carrera, D, Martinez, R, de la Rubia, J, Martin, A, Gonzalez, Y, Blade, J, Lahuerta, JJ, Orfao, A, San-Miguel, JF
Publicada:
12 nov 2009
Resumen:
Multiparameter flow cytometry immunophenotyping allows discrimination between normal (N-) and myelomatous (MM-) plasma cells (PCs) within the bone marrow plasma cell compartment (BMPCs). Here we report on the prognostic relevance of detecting more than 5% residual normal plasma cells from all bone marrow plasma cells (N-PCs/BMPCs) by multiparameter flow cytometry in a series of 594 newly diagnosed symptomatic MM patients, uniformly treated according to the Grupo Espanol de MM 2000 (GEM2000) protocol. Our results show that symptomatic MM patients with more than 5% N-PCs/BMPCs (n = 80 of 594; 14%) have a favorable baseline clinical prospect, together with a significantly lower frequency of high-risk cytogenetic abnormalities and higher response rates. Moreover, this group of patients had a significantly longer progression-free survival (median, 54 vs 42 months, P = .001) and overall survival (median, not reached vs 89 months, P = .04) than patients with less than or equal to 5% N-PCs/BMPCs. Our findings support the clinical value of detecting residual normal PCs in MM patients at diagnosis because this reveals a good prognostic category that could benefit from specific therapeutic approaches. This trial was registered at www.clinicaltrials.gov as NCT00560053. (Blood. 2009;114:4369-4372)
Filiaciones:
Paiva, B:
Hosp Univ Salamanca, Salamanca 37007, Spain
Vidriales, MB:
Hosp Univ Salamanca, Salamanca 37007, Spain
Ctr Invest Canc, Salamanca, Spain
Mateo, G:
Hosp Univ Salamanca, Salamanca 37007, Spain
Ctr Invest Canc, Salamanca, Spain
Perez, JJ:
Hosp Univ Salamanca, Salamanca 37007, Spain
Montalban, MA:
Hosp 12 Octubre, E-28041 Madrid, Spain
Sureda, A:
Hosp Santa Crue & Sani Pau, E-08025 Barcelona, Spain
Montejano, L:
Hosp 12 Octubre, E-28041 Madrid, Spain
Gutierrez, NC:
Hosp Univ Salamanca, Salamanca 37007, Spain
Ctr Invest Canc, Salamanca, Spain
de Coca, AG:
Univ Valladolid, Hosp Clin, Valladolid, Spain
de las Heras, N:
Complejo Hosp Leon, Leon, Spain
Mateos, MV:
Hosp Univ Salamanca, Salamanca 37007, Spain
Ctr Invest Canc, Salamanca, Spain
Lopez-Berges, MC:
Hosp Univ Salamanca, Salamanca 37007, Spain
Garcia-Boyero, R:
Hosp Gen Castellon, Castellon De La Plana, Spain
Galende, J:
Hosp Bierzo, Ponferrada, Spain
Hernandez, J:
Hosp Gen Segovia, Segovia, Spain
Palomera, L:
Hosp Lozano Blesa, Zaragoza, Spain
Carrera, D:
Univ Oviedo, Hosp Cent Asturias, E-33080 Oviedo, Spain
Martinez, R:
Clin San Carlos, Madrid, Spain
de la Rubia, J:
Hosp La Fe, E-46009 Valencia, Spain
Martin, A:
Hosp Virgen Concha, Zamora, Spain
Gonzalez, Y:
Hosp Dr Josep Trueta, Girona, Spain
Blade, J:
Hosp Clin Barcelona, Inst Invest Biomed August Pi & Sunyer Barcelona, Barcelona, Spain
Lahuerta, JJ:
Hosp 12 Octubre, E-28041 Madrid, Spain
Orfao, A:
Ctr Invest Canc, Salamanca, Spain
Univ Salamanca, Serv Gen Citometria, E-37008 Salamanca, Spain
San-Miguel, JF:
Hosp Univ Salamanca, Salamanca 37007, Spain
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