Relationship between circulating plasma cells and high-risk multiple myeloma and immunoglobulin gene rearrangement
REN Huijuan
SU Xiaotian
CHEN Qiuyu
LIU Jian
Abstract：Objective To investigate the prognostic significance of circulating plasma cells(CPC)and the relationship between immunoglobulin(IG)gene rearrangement.Methods One hundred and eighteennewly diagnosed MM patients in our hospital from January 2017 to December 2019 were collected.Multi parameter flow cytometry(MFC)was used to quantify CPC and bone marrow plasma cells(BMPC),and IGH FR1 and IGK primers were used based on NGS to perform clonal testing of IG heavy chain(IGH)and light chain(IGK)genes,determining the relationship between CPC levels and clinical pathological features and IG rearrangement.Results CPC level of 118 patients was 0.02%(0,0.14),and they were divided into low CPC group and high CPC group based on the median CPC level of 0.02%.CPC and improved ISS staging,R2-ISS staging β-2.Microglobulin,lactate dehydrogenase,hemoglobin,and BMPC/total lymphocyte ratio were correlated(P＜0.05).After logarithmic transformation of CPC levels,there was a positive correlation between CPC and the proportion of plasma cells in BM nucleated cells or total lymphocytes,with rs=0.239(P=0.009)and rs =0.317(P＜0.001).The median follow-up was 39.5 months.Improved ISS cannot distinguish the OS difference between stage Ⅱ and stage Ⅲ(P=0.361).However,for further stratification of patients with improved ISS stage Ⅱ and Ⅲ,the median OS time was 33.50 months in the high CPC group and 58.30 months in the low CPC group,respectively,with a statistically significant difference(P=0.037).In patients with(+)or without(-)clonal IGH rearrangement,the CPC ratios were 0.025%(0.00,0.17)and 0.01%(0.00,0.13),respectively,with P = 0.027.In addition,among patients with clonal IGH rearrangement(+)and/or IGK rearrangement(+),the CPC ratio was 0.03%(0.00,0.15),higher than in patients with clonal IGH rearrangement(-)and IGK rearrangement(-)[0.01%(0.00,0.015),P= 0.030].Conclusion High level CPC can predict high-risk MM,and IGH rearrangement is more common in patients with high CPC group,providing additional prognostic information for improving ISS risk stratification,especially for stage Ⅱ-Ⅲ MM patients.
Keywords：Multiple myelomaCirculating plasma cellPrognosisGenetic characteristicsImmunoglobulin gene rearrangement
Publication Date：2023-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 887-892 )