Portal de investigación
Circulating Tumor and Immune Cells for Minimally Invasive Risk Stratification of Smoldering Multiple Myeloma
Fecha de publicación:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Termini R.
- Žihala D.
- Terpos E.
- Perez-Montaña A.
- Jelínek T.
- Raab M.
- Weinhold N.
- Mai E.K.
- Grab A.L.
- Corre J.
- Vergez F.
- Sacco A.
- Chiarini M.
- Giustini V.
- Tucci A.
- Rodriguez S.
- Moreno C.
- Perez C.
- Maia C.
- Martín-Sánche E.
- Guerrero C.
- Botta C.
- Garces J.-J.
- Lopez A.
- Tamariz-Amador L.-E.
- Prosper F.
- Bargay J.
- Cabezudo M.-E.
- Ocio E.M.
- Hájek R.
- Martinez-Lope J.
- Solano F.
- Iglesias R.
- Paiva A.
- Geraldes C.
- Vitoria H.
- Gomez C.
- De Arriba F.
- Ludwig H.
- Garcia-Guiñon A.
- Casanova M.
- Alegre A.
- Cabañas V.
- Sirvent M.
- Oriol A.
- Hernández-Rivas J.A.
- Palomera L.
- Sarasa M.
- Rios P.
- Puig N.
- Mateos M.-V.
- Flores-Monter J.
- Orfao A.
- Goldschmidt H.
- Avet-Loisea H.
- Roccaro A.M.
- San-Miguel J.F.
- Paiva B.
Grupos
Abstract
Purpose: Early intervention in smoldering multiple myeloma (SMM) requires optimal risk stratification to avoid under- and overtreatment. We hypothesized that replacing bone marrow (BM) plasma cells (PC) for circulating tumor cells (CTC), and adding immune biomarkers in peripheral blood (PB) for the identification of patients at risk of progression due to lost immune surveillance, could improve the International Myeloma Working Group 20/2/20 model. Experimental Design: We report the outcomes of 150 patients with SMM enrolled in the iMMunocell study, in which serial assessment of tumor and immune cells in PB was performed every 6 months for a period of 3 years since enrollment. Results: Patients with >0.015% versus =0.015% CTCs at baseline had a median time-to-progression of 17 months versus not reached (HR, 4.9; P < 0.001). Presence of >20% BM PCs had no prognostic value in a multivariate analysis that included serum free light-chain ratio >20, >2 g/dL M-protein, and >0.015% CTCs. The 20/2/20 and 20/2/0.015 models yielded similar risk stratification (C-index of 0.76 and 0.78). The combination of the 20/2/0.015 model with an immune risk score based on the percentages of SLAN+ and SLAN nonclassical monocytes, CD69+HLADR+ cytotoxic NK cells, and CD4+CXCR3+ stem central memory T cells, allowed patient' stratification into low, intermediate-low, intermediatehigh, and high-risk disease with 0%, 20%, 39%, and 73% rates of progression at 2 years. Conclusions: This study showed that CTCs outperform BM PCs for assessing tumor burden. Additional analysis in larger series are needed to define a consensus cutoff of CTCs for minimally invasive stratification of SMM. © 2022 American Association for Cancer Research.
Datos de la publicación
- ISSN/ISSNe:
- 1078-0432, 1557-3265
- Tipo:
- Article
- Páginas:
- 4771-4781
- PubMed:
- 36074126
- Enlace a otro recurso:
- www.scopus.com
- Factor de Impacto:
- 4,399 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
CLINICAL CANCER RESEARCH AMER ASSOC CANCER RESEARCH
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- No hay documentos
Filiaciones
Keywords
- Disease Progression; Humans; Immunoglobulin Light Chains; Multiple Myeloma; Prognosis; Risk Assessment; Smoldering Multiple Myeloma; CD69 antigen; chemokine receptor CXCR3; tumor marker; immunoglobulin light chain; adult; aged; analytical parameters; Article; blood analysis; cancer growth; cancer risk; CD4+ T lymphocyte; circulating tumor cell; controlled study; disease risk assessment; female; flow cytometry; high risk patient; human; human cell; immune risk score; immunocompetent cell; immunosurveillance; intermediate risk patient; low risk patient; major clinical study; male; memory T lymphocyte; natural killer cell; outcome assessment; plasma cell; risk assessment; serum free light chain ratio; smoldering multiple myeloma; standardization; tumor cell; tumor volume; disease exacerbation; multiple myeloma; prognosis