title: Prognostic value of immunophenotyping in multiple myeloma: a study by the PETHEMA/GEM cooperative study groups on patients uniformly treated with high-dose therapy.
abstract: OBJECTIVE
  To analyze the prognostic impact of immunophenotyping in patients with multiple myeloma (MM).
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Our 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).
  
  
  CONCLUSIONS
  To 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.
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Mateo
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Montalbán
authors.forename: Maria-Belén
authors.initials: MB
authors.lastname: Vidriales
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Lahuerta
authors.forename: Maria V
authors.initials: MV
authors.lastname: Mateos
authors.forename: Norma
authors.initials: N
authors.lastname: Gutiérrez
authors.forename: Laura
authors.initials: L
authors.lastname: Rosiñol
authors.forename: Laura
authors.initials: L
authors.lastname: Montejano
authors.forename: Joan
authors.initials: J
authors.lastname: Bladé
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.forename: Joaquín
authors.initials: J
authors.lastname: Diaz-Mediavilla
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: José M
authors.initials: JM
authors.lastname: Ribera
authors.forename: José M
authors.initials: JM
authors.lastname: Ojanguren
authors.forename: Felipe
authors.initials: F
authors.lastname: de Arriba
authors.forename: Luis
authors.initials: L
authors.lastname: Palomera
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Terol
authors.forename: Alberto
authors.initials: A
authors.lastname: Orfao
authors.forename: Jesús F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000276:immunology* / Q000502:physiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000235:genetics / Q000276:immunology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor