Prognostic impact of circulating plasma cells in patients with multiple myeloma: Implications for plasma cell leukemia definition

Miquel Granell, Xavier Calvo, Antoni Garcia-Guiñón, Lourdes Escoda, Eugènia Abella, Clara Ma Martínez, Montserrat Teixidó, Ma Teresa Gimenez, Alicia Senín, Patricia Sanz, Desirée Campoy, Ana Vicent, Leonor Arenillas, Laura Rosiñol, Jorge Sierra, Joan Bladé, Carlos Fernández De Larrea

Research output: Contribution to journalArticleResearchpeer-review

23 Citations (Scopus)

Abstract

© 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.
Original languageEnglish
Pages (from-to)1099-1104
JournalHaematologica
Volume102
Issue number6
DOIs
Publication statusPublished - 1 Jan 2017

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