The prognostic significance of CD45 expression by clonal bone marrow plasma cells in patients with newly diagnosed multiple myeloma.
The prognostic significance of CD45 expression by clonal bone marrow plasma cells in patients with newly diagnosed multiple myeloma.
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DOI：
10.1016/j.leukres.2016.03.003
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发表时间：
2016-05
影响因子：
2.7
通讯作者：
Kumar SK
中科院分区：
文献类型：
--
作者：
Gonsalves WI;Timm MM;Rajkumar SV;Morice WG;Dispenzieri A;Buadi FK;Lacy MQ;Dingli D;Leung N;Kapoor P;Kyle RA;Gertz MA;Kumar SK
对多发性骨髓瘤（MM）患者骨髓（BM）中克隆浆细胞（PC）的评价显示，基于是否存在CD 45表达，存在两种不同的克隆PC群体。我们探讨了新药物治疗时代MM患者BM中克隆PC的CD 45表达的预后意义。纳入了2009年至2011年在马约诊所（罗切斯特）接受多参数流式细胞术评价BM的所有156例MM患者。BM中表达CD 45的克隆PC ≥ 20%的患者被归类为CD 45阳性（+），其余患者被归类为CD 45阴性（-）。在这些患者中，CD 45（+）组患者（n = 43，28%）的中位总生存期（OS）为38个月，而CD 45（-）组患者（n = 113，72%）未达到（P = 0.009）。在多变量分析中，CD 45（+）状态是新诊断MM患者OS较差的独立预测因子。CD 45表达可能是MM更具侵袭性表型的替代物，需要进一步研究。
Evaluation of clonal plasma cells (PCs) in the bone marrow (BM) of multiple myeloma (MM) patients reveals two distinct clonal PC populations based on the presence or absence of CD45 expression. We explored the prognostic significance of CD45 expression by clonal PCs in the BM of MM patients in the era of novel agent therapy. All 156 MM patients seen at the Mayo Clinic, Rochester from 2009 to 2011 who had their BM evaluated by multiparametric flow cytometry were included. Patients whose BM had ≥ 20% of the clonal PCs expressing CD45 were classified as CD45 positive (+) and the rest as CD45 negative (−). Of these patients, the median overall survival (OS) for patients in the CD45 (+) group (n = 43, 28%) was 38 months versus not reached for the CD45 (−) group (n = 113, 72%) (P = 0.009). In a multivariable analysis, CD45 (+) status was an independent predictor of inferior OS among newly diagnosed patients with MM. CD45 expression may be a surrogate for a more aggressive phenotype of MM and warrants further investigation.