학술논문
Graded Depth of Response and Neoplastic Plasma Cell Index as Indicators of Survival Outcomes in Patients With Multiple Myeloma Following Autologous Stem Cell Transplant
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Academic Journal
Author
Source
American Journal of Clinical Pathology. January 2023, Vol. 159 Issue 1, p69, 12 p.
Subject
Language
English
ISSN
0002-9173
Abstract
INTRODUCTION The current standard of care in multiple myeloma (MM) includes induction therapy with a combination of proteasome inhibitor/ immunomodulatory drug/monoclonal antibody conjugate followed by autologous stem cell transplant (ASCT) [...]
Objectives: With a substantial number of patients with multiple myeloma (MM) experiencing disease relapse, the quest for more sensitive methods to assess deeper responses indicative of cure continues. Methods: In this prospective analysis of 170 patients with MM at day 100 after autologous stem cell transplant, we evaluated the predictive value of conventional response, measurable residual disease ([MRD.sub.TOTAL]: the aberrant percentage of plasma cells [PC%] among total bone marrow cells), and neoplastic plasma cell index scores (NPCI: the aberrant PC% of total PCs). Results: Significantly better progression-free survival (PFS) and overall survival (OS) were observed with deepening conventional response. Conventional response-based stratification within the MRD-positive and MRD-negative subgroups showed a significantly higher PFS (hazard ratio [HR], 3.11; P Conclusions: Progressive deepening of response, conventional as well as MRD, correlates with superior survival outcomes. The NPCI proved to be a superior determinant of survival and can be explored as a better statistic than MRD. KEY WORDS Multiparametric flow cytometry; Measurable residual disease; Autologous stem cell transplant; K-adaptive partitioning; Neoplastic plasma cell index
Objectives: With a substantial number of patients with multiple myeloma (MM) experiencing disease relapse, the quest for more sensitive methods to assess deeper responses indicative of cure continues. Methods: In this prospective analysis of 170 patients with MM at day 100 after autologous stem cell transplant, we evaluated the predictive value of conventional response, measurable residual disease ([MRD.sub.TOTAL]: the aberrant percentage of plasma cells [PC%] among total bone marrow cells), and neoplastic plasma cell index scores (NPCI: the aberrant PC% of total PCs). Results: Significantly better progression-free survival (PFS) and overall survival (OS) were observed with deepening conventional response. Conventional response-based stratification within the MRD-positive and MRD-negative subgroups showed a significantly higher PFS (hazard ratio [HR], 3.11; P Conclusions: Progressive deepening of response, conventional as well as MRD, correlates with superior survival outcomes. The NPCI proved to be a superior determinant of survival and can be explored as a better statistic than MRD. KEY WORDS Multiparametric flow cytometry; Measurable residual disease; Autologous stem cell transplant; K-adaptive partitioning; Neoplastic plasma cell index