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Title:
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Prognostic impact of circulating plasma cells in patients with multiple myeloma: implications for plasma cell leukemia definition
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Author:
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Granell, Miquel; Calvo, Xavier; Garcia-Guiñón, Antoni; Escoda, Lourdes; Abella, Eugènia; Martínez, Clara Mª; Teixidó, Montserrat; Gimenez, Mª Teresa; Senín, Alicia; Sanz, Patricia; Campoy, Desirée; Vicent, Ana; Arenillas, Leonor; Rosiñol, Laura; Sierra, Jorge; Bladé, Joan; Fernández de Larrea, Carlos
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Other authors:
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GEMMAC (Grup per l’estudi del mieloma i l’amiloïdosi de Catalunya) |
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Notes:
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The presence of circulating plasma cells in patients with multiple myeloma is considered a marker for highly proliferative disease. In the study herein, the impact of circulating plasma cells assessed by cytology on survival of patients with multiple myeloma was analyzed. Wright-Giemsa stained peripheral blood smears of 482 patients with newly diagnosed myeloma or plasma cell leukemia were reviewed and patients were classified into 4 categories according to the percentage of circulating plasma cells: 0%, 1–4%, 5–20%, and plasma cell leukemia with the following frequencies: 382 (79.2%), 83 (17.2%), 12 (2.5%) and 5 (1.0%), respectively. Median overall survival according to the circulating plasma cells group was 47, 50, 6 and 14 months, respectively. At multivariate analysis, the presence of 5 to 20% circulating plasma cells was associated with a worse overall survival (relative risk 4.9, 95% CI 2.6–9.3) independently of age, creatinine, the Durie-Salmon system stage and the International Staging System (ISS) stage. Patients with ≥5% circulating plasma cells had lower platelet counts (median 86×109/L vs. 214×109/L, P<0.0001) and higher bone marrow plasma cells (median 53% vs. 36%, P=0.004). The presence of ≥5% circulating plasma cells in patients with multiple myeloma has a similar adverse prognostic impact as plasma cell leukemia.
his study was supported in part by grants AGAUR 2014SGR-1281 and 2014SGR-552 (Generalitat de Catalunya), and RD12/0036/0071, RD12/0036/0046 and PI16/00423 (Instituto de Salud Carlos III) and Fondo Europeo de Desarrollo Regional (FEDER) as well as a grant from the Cellex Research Foundation, Barcelona, Spain. |
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Subject(s):
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-Mieloma múltiple |
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Rights:
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cc-by-nc (c) Ferrata Storti Foundation, 2017
http://creativecommons.org/licenses/by-nc/4.0/
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Document type:
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Article
Article - Published version |
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Published by:
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Ferrata Storti Foundation;
European Hematology Association
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