Prognostic value of immunophenotyping in multiple myeloma:: A study by the PETHEMA/GEM cooperative study groups on patients uniformly treated with high-dose therapy
Prognostic value of immunophenotyping in multiple myeloma:: A study by the PETHEMA/GEM cooperative study groups on patients uniformly treated with high-dose therapy
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DOI：
10.1200/jco.2007.15.4120
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发表时间：
2008-06-01
影响因子：
45.3
通讯作者：
Miguel, Jesus F. San
中科院分区：
文献类型：
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作者：
Mateo, Gema;Montalban, M. Angeles;Miguel, Jesus F. San
目的分析免疫表型对多发性骨髓瘤(MM)患者预后的影响。方法采用多参数流式细胞术对685例新诊断的MM患者进行前瞻性分析。结果CD19和CD28的表达以及CD117的缺失与MM患者的无进展生存期(PFS)和总生存期(OS)显著缩短。有趣的是，CD28表达与t(14；16)和del(17p)相关，而CD117阴性患者与t(4；14)和del(13q)相关。同时评估CD28和CD117抗原可将MM患者分为三种危险类型：低风险(CD28阳性CD117阴性)、中等(两者均阴性或两者均阳性)和良好风险(CD28阴性CD117阳性)，PFS分别为30、37和45个月(P=0.01)，OS率分别为45、68和未达到(P=0.0001)。结论据我们所知，这是首次在一大系列统一治疗的患者中同时分析相对较高数量的抗原标记对预后的影响。研究表明，MM患者骨髓浆细胞上几种抗原(尤其是CD28和CD117)的表达有助于识别进展风险较高的患者。
PurposeTo analyze the prognostic impact of immunophenotyping in patients with multiple myeloma ( MM).Patients and MethodsWe have prospectively analyzed the prognostic impact of antigenic markers, assessed by multiparametric flow cytometry, in a series of 685 newly diagnosed MM patients that were uniformly treated according to the GEM 2000 protocol.ResultsOur results show that expression of both CD19 and CD28 as well as the absence of CD117 were associated with a significantly shorter progression free-survival ( PFS) and overall survival ( OS). Interestingly, the CD28 expression correlated with t(14; 16) and del(17p), while CD117-negative patients were associated with t( 4; 14) and del( 13q). Simultaneous assessment of CD28 and CD117 antigens allowed stratification of patients with MM into three risk categories: poor risk ( CD28 positive CD117 negative), intermediate ( either both markers negative or both positive), and good risk ( CD28 negative CD117 positive), with PFS rates of 30, 37, and 45 months, respectively ( P =.01), and OS rates of 45, 68, and not reached, respectively ( P =.0001).ConclusionTo the best of our knowledge, this is the first prospective analysis in which the prognostic impact of a relatively high number of antigenic markers has been simultaneously analyzed in a large series of uniformly treated patients, showing that the expression of several antigens ( particularly CD28 and CD117) on bone marrow plasma cells from patients with MM can help to identify patients at high risk of progression.