Title |
Prognostic value of antigen expression in multiple myeloma: a PETHEMA/GEM study on 1265 patients enrolled in four consecutive clinical trials
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Published in |
Leukemia, November 2017
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DOI | 10.1038/leu.2017.320 |
Pubmed ID | |
Authors |
P Arana, B Paiva, M-T Cedena, N Puig, L Cordon, M-B Vidriales, N C Gutierrez, F Chiodi, L Burgos, L-L Anglada, J Martinez-Lopez, M-T Hernandez, A-I Teruel, M Gironella, M-A Echeveste, L Rosiñol, R Martinez, A Oriol, J De la Rubia, A Orfao, J Blade, J-J Lahuerta, M-V Mateos, J-F San Miguel |
Abstract |
Persistence of minimal residual disease (MRD) after treatment for myeloma predicts inferior outcomes, but within MRD-positive patients there is great heterogeneity with both early and very late relapses. Amongst different MRD techniques, flow cytometry provides additional information about antigen expression on tumor cells, which could potentially contribute to stratify MRD-positive patients. We investigated the prognostic value of those antigens required to monitor MRD in 1265 newly-diagnosed patients enrolled in the GEM2000, GEM2005MENOS65, GEM2005MAS65 and GEM2010MAS65 protocols. Overall, CD19(pos), CD27(neg), CD38(lo), CD45(pos), CD81(pos), CD117(neg) and CD138(lo) expression predicted inferior outcomes. Through principal-component-analysis, we found that simultaneous CD38(low)CD81(pos)CD117(neg) expression emerged as the most powerful combination with independent prognostic value for progression-free survival (HR:1.69; P=0.002). This unique phenotypic profile retained prognostic value among MRD-positive patients. We then used next-generation flow to determine antigen stability throughout the course of the disease, and found that the expression of antigens required to monitor MRD is mostly stable from diagnosis to MRD stages, except for CD81 whose expression progressively increased from baseline to chemoresistant tumor cells (14 vs 28%). Altogether, we showed that the phenotypic profile of tumor cells provides additional prognostic information, and could be used to further predict risk of relapse among MRD-positive patients.Leukemia accepted article preview online, 03 November 2017. doi:10.1038/leu.2017.320. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 3 | 21% |
Spain | 3 | 21% |
Saudi Arabia | 1 | 7% |
Canada | 1 | 7% |
United Kingdom | 1 | 7% |
Unknown | 5 | 36% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 9 | 64% |
Scientists | 3 | 21% |
Practitioners (doctors, other healthcare professionals) | 2 | 14% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 72 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 19 | 26% |
Other | 12 | 17% |
Student > Ph. D. Student | 7 | 10% |
Student > Doctoral Student | 5 | 7% |
Student > Master | 4 | 6% |
Other | 13 | 18% |
Unknown | 12 | 17% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 30 | 42% |
Biochemistry, Genetics and Molecular Biology | 11 | 15% |
Immunology and Microbiology | 6 | 8% |
Agricultural and Biological Sciences | 3 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
Other | 5 | 7% |
Unknown | 14 | 19% |