TY - JOUR
T1 - Prognostic impact of circulating plasma cells in patients with multiple myeloma: Implications for plasma cell leukemia definition
AU - Granell, Miquel
AU - Calvo, Xavier
AU - Garcia-Guiñón, Antoni
AU - Escoda, Lourdes
AU - Abella, Eugènia
AU - Martínez, Clara Ma
AU - Teixidó, Montserrat
AU - Teresa Gimenez, Ma
AU - Senín, Alicia
AU - Sanz, Patricia
AU - Campoy, Desirée
AU - Vicent, Ana
AU - Arenillas, Leonor
AU - Rosiñol, Laura
AU - Sierra, Jorge
AU - Bladé, Joan
AU - De Larrea, Carlos Fernández
PY - 2017/1/1
Y1 - 2017/1/1
N2 - © 2017 Ferrata Storti Foundation. The presence of circulating plasma cells in patients with multiple myeloma is considered a marker for highly proliferative disease. In the study herein, the impact of circulating plasma cells assessed by cytology on survival of patients with multiple myeloma was analyzed. Wright-Giemsa stained peripheral blood smears of 482 patients with newly diagnosed myeloma or plasma cell leukemia were reviewed and patients were classified into 4 categories according to the percentage of circulating plasma cells: 0%, 1-4%, 5-20%, and plasma cell leukemia with the following frequencies: 382 (79.2%), 83 (17.2%), 12 (2.5%) and 5 (1.0%), respectively. Median overall survival according to the circulating plasma cells group was 47, 50, 6 and 14 months, respectively. At multivariate analysis, the presence of 5 to 20% circulating plasma cells was associated with a worse overall survival (relative risk 4.9, 95%CI 2.6-9.3) independently of age, creatinine, the Durie-Salmon system stage and the International Staging System (ISS) stage. Patients with ≥5% circulating plasma cells had lower platelet counts (median 86x109/L vs. 214x109/L, P<0.0001) and higher bone marrow plasma cells (median 53% vs. 36%, P=0.004). The presence of ≥5% circulating plasma cells in patients with multiple myeloma has a similar adverse prognostic impact as plasma cell leukemia.
AB - © 2017 Ferrata Storti Foundation. The presence of circulating plasma cells in patients with multiple myeloma is considered a marker for highly proliferative disease. In the study herein, the impact of circulating plasma cells assessed by cytology on survival of patients with multiple myeloma was analyzed. Wright-Giemsa stained peripheral blood smears of 482 patients with newly diagnosed myeloma or plasma cell leukemia were reviewed and patients were classified into 4 categories according to the percentage of circulating plasma cells: 0%, 1-4%, 5-20%, and plasma cell leukemia with the following frequencies: 382 (79.2%), 83 (17.2%), 12 (2.5%) and 5 (1.0%), respectively. Median overall survival according to the circulating plasma cells group was 47, 50, 6 and 14 months, respectively. At multivariate analysis, the presence of 5 to 20% circulating plasma cells was associated with a worse overall survival (relative risk 4.9, 95%CI 2.6-9.3) independently of age, creatinine, the Durie-Salmon system stage and the International Staging System (ISS) stage. Patients with ≥5% circulating plasma cells had lower platelet counts (median 86x109/L vs. 214x109/L, P<0.0001) and higher bone marrow plasma cells (median 53% vs. 36%, P=0.004). The presence of ≥5% circulating plasma cells in patients with multiple myeloma has a similar adverse prognostic impact as plasma cell leukemia.
U2 - 10.3324/haematol.2016.158303
DO - 10.3324/haematol.2016.158303
M3 - Article
SN - 0390-6078
VL - 102
SP - 1099
EP - 1104
JO - Haematologica
JF - Haematologica
IS - 6
ER -