Plasma cell proliferative index post-transplant is a powerful predictor of prognosis in myeloma patients failing to achieve a complete response

M. Hasib Sidiqi, Mohammed A. Aljama, Dragan Jevremovic, William G. Morice, Michael Timm, Francis K. Buadi, Rahma Warsame, Martha Lacy, Angela Dispenzieri, David M Dingli, Wilson Gonsalves, Shaji K Kumar, Prashant Kapoor, Taxiarchis Kourelis, Nelson Leung, William Hogan, Eli Muchtar, John A. Lust, S Vincent Rajkumar, Morie Gertz

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Abstract

Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI). The remaining 40% (n = 152) of patients had PCPI performed with 79% (n = 120) having a low PCPI and 21% (n = 32) having an elevated PCPI. Patients with an elevated PCPI had significantly shorter progression free and overall survival. The median PFS was 8 months for elevated PCPI vs. 19 months for low PCPI vs. 24 months for no PCPI (p < 0.0001). The median OS was 27 months for elevated PCPI vs. 79 months for low PCPI vs. not reached for no PCPI, p < 0.0001). On multivariable analysis post-therapy PCPI was an independent predictor of progression free and overall survival. The PCPI post-therapy is a powerful predictor of survival and risk stratifies myeloma patients failing to achieve complete response early in the disease course.

Original languageEnglish (US)
JournalBone Marrow Transplantation
DOIs
StateAccepted/In press - Jan 1 2018

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Plasma Cells
Transplants
Disease-Free Survival
Stem Cell Transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Plasma cell proliferative index post-transplant is a powerful predictor of prognosis in myeloma patients failing to achieve a complete response",
abstract = "Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI). The remaining 40{\%} (n = 152) of patients had PCPI performed with 79{\%} (n = 120) having a low PCPI and 21{\%} (n = 32) having an elevated PCPI. Patients with an elevated PCPI had significantly shorter progression free and overall survival. The median PFS was 8 months for elevated PCPI vs. 19 months for low PCPI vs. 24 months for no PCPI (p < 0.0001). The median OS was 27 months for elevated PCPI vs. 79 months for low PCPI vs. not reached for no PCPI, p < 0.0001). On multivariable analysis post-therapy PCPI was an independent predictor of progression free and overall survival. The PCPI post-therapy is a powerful predictor of survival and risk stratifies myeloma patients failing to achieve complete response early in the disease course.",
author = "Sidiqi, {M. Hasib} and Aljama, {Mohammed A.} and Dragan Jevremovic and Morice, {William G.} and Michael Timm and Buadi, {Francis K.} and Rahma Warsame and Martha Lacy and Angela Dispenzieri and Dingli, {David M} and Wilson Gonsalves and Kumar, {Shaji K} and Prashant Kapoor and Taxiarchis Kourelis and Nelson Leung and William Hogan and Eli Muchtar and Lust, {John A.} and Rajkumar, {S Vincent} and Morie Gertz",
year = "2018",
month = "1",
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language = "English (US)",
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T1 - Plasma cell proliferative index post-transplant is a powerful predictor of prognosis in myeloma patients failing to achieve a complete response

AU - Sidiqi, M. Hasib

AU - Aljama, Mohammed A.

AU - Jevremovic, Dragan

AU - Morice, William G.

AU - Timm, Michael

AU - Buadi, Francis K.

AU - Warsame, Rahma

AU - Lacy, Martha

AU - Dispenzieri, Angela

AU - Dingli, David M

AU - Gonsalves, Wilson

AU - Kumar, Shaji K

AU - Kapoor, Prashant

AU - Kourelis, Taxiarchis

AU - Leung, Nelson

AU - Hogan, William

AU - Muchtar, Eli

AU - Lust, John A.

AU - Rajkumar, S Vincent

AU - Gertz, Morie

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI). The remaining 40% (n = 152) of patients had PCPI performed with 79% (n = 120) having a low PCPI and 21% (n = 32) having an elevated PCPI. Patients with an elevated PCPI had significantly shorter progression free and overall survival. The median PFS was 8 months for elevated PCPI vs. 19 months for low PCPI vs. 24 months for no PCPI (p < 0.0001). The median OS was 27 months for elevated PCPI vs. 79 months for low PCPI vs. not reached for no PCPI, p < 0.0001). On multivariable analysis post-therapy PCPI was an independent predictor of progression free and overall survival. The PCPI post-therapy is a powerful predictor of survival and risk stratifies myeloma patients failing to achieve complete response early in the disease course.

AB - Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI). The remaining 40% (n = 152) of patients had PCPI performed with 79% (n = 120) having a low PCPI and 21% (n = 32) having an elevated PCPI. Patients with an elevated PCPI had significantly shorter progression free and overall survival. The median PFS was 8 months for elevated PCPI vs. 19 months for low PCPI vs. 24 months for no PCPI (p < 0.0001). The median OS was 27 months for elevated PCPI vs. 79 months for low PCPI vs. not reached for no PCPI, p < 0.0001). On multivariable analysis post-therapy PCPI was an independent predictor of progression free and overall survival. The PCPI post-therapy is a powerful predictor of survival and risk stratifies myeloma patients failing to achieve complete response early in the disease course.

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U2 - 10.1038/s41409-018-0280-8

DO - 10.1038/s41409-018-0280-8

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JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

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