title: Circulating plasma cells detected by flow cytometry as a predictor of survival in 302 patients with newly diagnosed multiple myeloma.
abstract: 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.
authors.affiliation: Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
authors.forename: Grzegorz S
authors.initials: GS
authors.lastname: Nowakowski
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Witzig
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.forename: Michal J
authors.initials: MJ
authors.lastname: Tracz
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.forename: John A
authors.initials: JA
authors.lastname: Lust
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Philip R
authors.initials: PR
authors.lastname: Greipp
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
mesh_terms: 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
chemical_list: D000418:Albumins; D009194:Myeloma Proteins; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D017493:Leukocyte Common Antigens