Cellular proliferation by multiplex immunohistochemistry identifies aggressive disease behavior in relapsed multiple myeloma.
Cellular proliferation by multiplex immunohistochemistry identifies aggressive disease behavior in relapsed multiple myeloma.
复制标题
通过多重免疫组织化学的细胞增殖鉴定复发性多发性骨髓瘤的侵袭性疾病行为。
DOI：
10.1080/10428194.2018.1551537
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发表时间：
2019
影响因子：
2.6
通讯作者：
Ely,Scott
中科院分区：
文献类型：
--
作者：
Forsberg,PeterA;Hammes,Andrew;Abbott,Diana;Sherbenou,DanielW;Rossi,Adriana;Jayabalan,David;Niesvizky,Ruben;Mark,TomerM;Ely,Scott
复发性和难治性多发性骨髓瘤（RRMM）的管理仍然具有挑战性，因为在这种情况下疾病的临床和遗传异质性以及提供者必须从中选择的越来越多的治疗选择[1，2]。需要预后生物标志物来帮助检测新出现的侵袭性疾病，这可能需要更密集的治疗方法。浆细胞增殖的评估是多发性骨髓瘤（MM）疾病行为的一个良好指标，但利用仍然有限。浆细胞标记指数（PCLI）是MM中一种有意义的预后工具，已在多种疾病环境中得到验证，但由于技术负担很少使用[3-5]。浆细胞增殖指数（PCPI）是一种用于CD 138和Ki 67表达的多重免疫组织化学（mIHC）技术，开发该技术仅用于定量MM患者骨髓标本中活跃循环的浆细胞[6-8]。先前发表的新诊断患者的结果表明，PCPI升高与初始MM治疗后较短的无进展（PFS）和总生存期（OS）相关[9]。在此，我们对MM患者进行了回顾性评估，比较诊断时的PCPI与复发时的PCPI。我们评估了复发时细胞周期率差异与后续治疗和总体临床course.An IRB批准的回顾性队列研究的结果之间的相关性，该研究通过询问机构的临床数据库进行，研究对象为在威尔康奈尔医学院接受治疗的MM患者。为了纳入分析，受试者必须根据国际骨髓瘤工作组（IMWG）标准诊断为MM，并在Cornell接受初始和复发治疗。只有在诊断时、初始骨髓瘤治疗前和复发时进行骨髓活检并有可用于PCPI的样本的患者才被纳入分析。
Management of relapsed and refractory multiple myeloma (RRMM) remains challenging given the clinical and genetic heterogeneity of disease in this setting and the increasing therapeutic options that providers must select from [1, 2]. Prognostic biomarkers are needed to aid in the detection of emerging aggressive disease which may warrant more intensive therapeutic approaches. Assessment of plasma cell proliferation is a welldescribed indicator of multiple myeloma (MM) disease behavior but utilization remains limited. The plasma cell labeling index (PCLI) is a meaningful prognostic tool in MM that has been validated in multiple disease settings but is rarely used due to technical burden [3-5]. The Plasma Cell Proliferation Index (PCPI) is a multiplex immunohistochemistry (mIHC) technique for CD138 and Ki67 expression, which was developed to solely quantify actively cycling plasma cells in bone marrow specimens of patients with MM [6-8]. Previously published results from newly diagnosed patients demonstrated that an elevated PCPI is associated with shorter progression-free (PFS) and overall survival (OS) following initial MM treatment [9]. Here, we performed a retrospective assessment of MM patients comparing PCPI at diagnosis to PCPI at relapse. We assess the correlation of cell cycling rate differences at relapse to outcomes with subsequent therapy and overall clinical course.An IRB-approved retrospective cohort study of patients with MM treated at Weill Cornell Medical College was performed by interrogation of the institutionLs clinical database. For inclusion in the analysis, subjects must have been diagnosed with MM per International Myeloma Working Group (IMWG) criteria and received initial and relapse therapies at Cornell. Only patients with marrow biopsies performed at diagnosis, prior to initial myeloma therapy and at relapse with samples available for PCPI were included in the analysis.