作者
Luzalba Sanoja-Flores,Juan Flores‐Montero,Juan-José Garcés,Bruno Paiva,Noemí Puig,Aránzazu García‐Mateo,Omar García-Sánchez,Alba Corral-Mateos,Leire Burgos,E Blanco,J Hernández-Martín,Robéria Mendonça de Pontes,María Díez-Campelo,Pamela Millacoy,Paula Rodríguez‐Otero,Felipe Prósper,Juana Merino,María‐Belén Vidriales,Ramón García‐Sanz,Alfonso E. Romero,Luis Palomera,Rafael Ríos-Tamayo,Martín Pérez‐Andrés,Juan F. Blanco,Marcos González,Jacques J. M. van Dongen,Brian G.M. Durie,María‐Victoria Mateos,Jesús F. San-Miguel,Alberto Órfão
摘要
Abstract Here, we investigated for the first time the frequency and number of circulating tumor plasma cells (CTPC) in peripheral blood (PB) of newly diagnosed patients with localized and systemic plasma cell neoplasms (PCN) using next-generation flow cytometry (NGF) and correlated our findings with the distinct diagnostic and prognostic categories of the disease. Overall, 508 samples from 264 newly diagnosed PCN patients, were studied. CTPC were detected in PB of all active multiple myeloma (MM; 100%), and smoldering MM (SMM) patients (100%), and in more than half (59%) monoclonal gammopathy of undetermined significance (MGUS) cases ( p <0.0001); in contrast, CTPC were present in a small fraction of solitary plasmacytoma patients (18%). Higher numbers of CTPC in PB were associated with higher levels of BM infiltration and more adverse prognostic features, together with shorter time to progression from MGUS to MM ( p <0.0001) and a shorter survival in MM patients with active disease requiring treatment ( p ≤ 0.03). In summary, the presence of CTPC in PB as assessed by NGF at diagnosis, emerges as a hallmark of disseminated PCN, higher numbers of PB CTPC being strongly associated with a malignant disease behavior and a poorer outcome of both MGUS and MM.