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Článek

PubMed

Záznam pochází z PubMed

Circulating Tumor and Immune Cells for Minimally Invasive Risk Stratification of Smoldering Multiple Myeloma

Clinical cancer research. 2022 Nov 01 ; 28 (21) : 4771-4781.

Clin Cancer Res
ISSN 1557-3265 | 1078-0432
Zdroj

Jazyk angličtina Země Spojené státy americké Médium print

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz https://www.medvik.cz/link/pmid36074126

PubMed 36074126
DOI 10.1158/1078-0432.ccr-22-1594
PII: 709129
Knihovny.cz E-zdroje

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
práce podpořená grantem MeSH
Názvy látek
lehké řetězce imunoglobulinů 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

Clinica Universidad de Navarra Centro de Investigacion Medica Aplicada CCUN CIBER ONC numbers CB16 12 00369 CB16 12 00489 Pamplona Spain

Department of Health Promotion Mother and Child Care Internal Medicine and Medical Specialties University of Palermo Palermo Italy

Department of Hematooncology University Hospital Ostrava and University of Ostrava Ostrava Czech Republic

Flow Cytometry Unit Coimbra Portugal

Heidelberg University Clinic Hospital Department of Internal Medicine 5 and National Center for Tumor Diseases Heidelberg Germany

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