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Circulating Tumor and Immune Cells for Minimally Invasive Risk Stratification of Smoldering Multiple Myeloma
R. Termini, D. Žihala, E. Terpos, A. Perez-Montaña, T. Jelínek, M. Raab, N. Weinhold, EK. Mai, AL. Grab, J. Corre, F. Vergez, A. Sacco, M. Chiarini, V. Giustini, A. Tucci, S. Rodriguez, C. Moreno, C. Perez, C. Maia, E. Martín-Sánchez, C....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
NLK
Free Medical Journals
od 1995 do Před 1 rokem
Freely Accessible Science Journals
od 1995
Open Access Digital Library
od 1995-01-01
Open Access Digital Library
od 1995-01-01
- MeSH
- doutnající mnohočetný myelom * MeSH
- hodnocení rizik MeSH
- lehké řetězce imunoglobulinů MeSH
- lidé MeSH
- mnohočetný myelom * diagnóza terapie MeSH
- prognóza MeSH
- progrese nemoci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Early intervention in smoldering multiple myeloma (SMM) requires optimal risk stratification to avoid under- and overtreatment. We hypothesized that replacing bone marrow (BM) plasma cells (PC) for circulating tumor cells (CTC), and adding immune biomarkers in peripheral blood (PB) for the identification of patients at risk of progression due to lost immune surveillance, could improve the International Myeloma Working Group 20/2/20 model. EXPERIMENTAL DESIGN: We report the outcomes of 150 patients with SMM enrolled in the iMMunocell study, in which serial assessment of tumor and immune cells in PB was performed every 6 months for a period of 3 years since enrollment. RESULTS: Patients with >0.015% versus ≤0.015% CTCs at baseline had a median time-to-progression of 17 months versus not reached (HR, 4.9; P < 0.001). Presence of >20% BM PCs had no prognostic value in a multivariate analysis that included serum free light-chain ratio >20, >2 g/dL M-protein, and >0.015% CTCs. The 20/2/20 and 20/2/0.015 models yielded similar risk stratification (C-index of 0.76 and 0.78). The combination of the 20/2/0.015 model with an immune risk score based on the percentages of SLAN+ and SLAN- nonclassical monocytes, CD69+HLADR+ cytotoxic NK cells, and CD4+CXCR3+ stem central memory T cells, allowed patient' stratification into low, intermediate-low, intermediate-high, and high-risk disease with 0%, 20%, 39%, and 73% rates of progression at 2 years. CONCLUSIONS: This study showed that CTCs outperform BM PCs for assessing tumor burden. Additional analysis in larger series are needed to define a consensus cutoff of CTCs for minimally invasive stratification of SMM.
ASST Spedali Civili di Brescia Brescia Italy
Centre de Recherche en Cancérologie de Toulouse Unité 1037 INSERM Toulouse France
Centro Hospitalare Universitário de Coimbra Coimbra Portugal
Flow Cytometry Unit Coimbra Portugal
Hospital Clinico Universitario Lozano Blesa Zaragoza Spain
Hospital Costa del Sol Marbella Marbella Spain
Hospital de Galdakao Vizcaya Spain
Hospital de la Princesa Madrid Spain
Hospital de Laredo Laredo Spain
Hospital de Sant Joan Despí Moisès Broggi ICO H Barcelona Spain
Hospital Morales Meseguer IMIB Arrixaca Universidad de Murcia Murcia Spain
Hospital Ntra Sra del Prado Talavera De La Reina Spain
Hospital Nuestra Señora de la Candelara Santa Cruz de Tenerife Spain
Hospital Sont LLatzer Palma de Mallorca Spain
Hospital Universitario 12 De Octubre Universidad Complutense CNIO Madrid Spain
Hospital Universitario Arnau de Vilanova Lleida Spain
Hospital Universitario de Donostia San Sebastián Spain
Hospital Universitario Infanta Leonor Departamento de Medicina Universidad Complutense Madrid Spain
Hospital Universitario Marqués de Valdecilla Universidad de Cantabria Santander Spain
Hospital Universitario Son Espases Palma Spain
Hospital Virgen de la Arrixaca de Murcia IMIB Arrixaca Universidad de Murcia Murcia Spain
Institut Català d'Oncologia Institut Josep Carreras Badalona Spain
MD Anderson Cancer Center Madrid Spain
National and Kapodistrian University of Athens School of Medicine Athens Greece
Wilhelminen Cancer Research Institute Clinic Ottakring Vienna Austria
Citace poskytuje Crossref.org
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