Circulating plasma cells detected by flow cytometry as a predictor of survival in 302 patients with newly diagnosed multiple myeloma.
We detected circulating plasma cells (PCs) by flow cytometry in 302 patients with newly diagnosed multiple myeloma (MM) by gating on CD38+CD45- cells. The number of circulating PCs per 50 000 mononuclear cells was reported. In 80 (27%) patients, no circulating PC were seen; 106 (35%) patients had 1 to 10 and 115 (38%) patients had more than 10 circulating PCs. Median overall survival for the 302 patients was 47 months. Patients with 10 or fewer circulating PCs had a median survival of 58.7 months, whereas patients with more than 10 circulating PCs had a median survival of 37.3 months (P = .001). On multivariate analysis, the prognostic value of circulating PCs was independent of beta2-microglobulin, albumin, and C-reactive protein. There was only a weak correlation between tumor mass and circulating PCs, suggesting that the appearance of circulating PCs may be a reflection of tumor biology. We conclude that the number of circulating PCs measured by flow cytometry in patients with newly diagnosed MM is an independent predictor of survival.
Nowakowski
Grzegorz S
GS
Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Witzig
Thomas E
TE
Dingli
David
D
Tracz
Michal J
MJ
Gertz
Morie A
MA
Lacy
Martha Q
MQ
Lust
John A
JA
Dispenzieri
Angela
A
Greipp
Philip R
PR
Kyle
Robert A
RA
Rajkumar
S Vincent
SV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism; D002097:C-Reactive Protein / Q000096:biosynthesis; D015331:Cohort Studies; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D017493:Leukocyte Common Antigens / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015999:Multivariate Analysis; D009194:Myeloma Proteins / Q000737:chemistry; D009360:Neoplastic Cells, Circulating / Q000378:metabolism; D010950:Plasma Cells / Q000166:cytology; D011379:Prognosis; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000097:blood
D000418:Albumins; D009194:Myeloma Proteins; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D017493:Leukocyte Common Antigens