Prognostic significance of circulating plasma cells by multi-parametric flow cytometry in light chain amyloidosis

Surbhi Sidana, Nidhi Tandon, Angela Dispenzieri, Morie Gertz, David M Dingli, Dragan Jevremovic, William G. Morice, Prashant Kapoor, Taxiarchis Kourelis, Martha Lacy, Suzanne R. Hayman, Francis K. Buadi, Nelson Leung, Ronald S. Go, Yi Lin, Stephen J Russell, John A. Lust, Steven R. Zeldenrust, Rahma Warsame, Yi L. HwaMiriam Hobbs, Amie Fonder, Robert A. Kyle, S Vincent Rajkumar, Shaji K Kumar, Wilson Gonsalves

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We evaluated the prognostic impact of clonal circulating plasma cells (cPCs) detected by six-color multi-parametric flow cytometry (MFC) in light chain (AL) amyloidosis at diagnosis. Of the 154 patients who underwent MFC, cPCs were detected in 42% (n = 65) patients. Median number of cPCs was 81 per 150,000 events (range: 6-17,844). High bone marrow plasma cell percentage was an independent predictor of presence of cPCs. Presence of cPCs at diagnosis was associated with inferior overall survival (OS) (90 vs. 98 months, p = 0.003) and inferior progression free survival (PFS) (31 vs. 52 months, p = 0.02). Estimated 1, 2 and 5 year OS in the two groups was: 74, 64 and 57 and 89, 87, and 80%, respectively. Estimated PFS at 1, 2, and 5 years was: 69, 56, and 23% and 80, 74, and 37%, respectively. Furthermore, the presence of cPCs at diagnosis was an independent adverse predictor of OS in multivariable analysis. Achieving a very-good partial response, or better, was able to overcome the adverse impact of cPCs at diagnosis. Patients with cPCs at diagnosis may warrant closer monitoring post-treatment, especially if they do not achieve a deep hematologic response.

Original languageEnglish (US)
Pages (from-to)1421-1426
Number of pages6
JournalLeukemia
Volume32
Issue number6
DOIs
StatePublished - Jun 1 2018

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Amyloidosis
Plasma Cells
Flow Cytometry
Light
Disease-Free Survival
Survival
Bone Marrow Cells
Color

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Prognostic significance of circulating plasma cells by multi-parametric flow cytometry in light chain amyloidosis. / Sidana, Surbhi; Tandon, Nidhi; Dispenzieri, Angela; Gertz, Morie; Dingli, David M; Jevremovic, Dragan; Morice, William G.; Kapoor, Prashant; Kourelis, Taxiarchis; Lacy, Martha; Hayman, Suzanne R.; Buadi, Francis K.; Leung, Nelson; Go, Ronald S.; Lin, Yi; Russell, Stephen J; Lust, John A.; Zeldenrust, Steven R.; Warsame, Rahma; Hwa, Yi L.; Hobbs, Miriam; Fonder, Amie; Kyle, Robert A.; Rajkumar, S Vincent; Kumar, Shaji K; Gonsalves, Wilson.

In: Leukemia, Vol. 32, No. 6, 01.06.2018, p. 1421-1426.

Research output: Contribution to journalArticle

Sidana, Surbhi ; Tandon, Nidhi ; Dispenzieri, Angela ; Gertz, Morie ; Dingli, David M ; Jevremovic, Dragan ; Morice, William G. ; Kapoor, Prashant ; Kourelis, Taxiarchis ; Lacy, Martha ; Hayman, Suzanne R. ; Buadi, Francis K. ; Leung, Nelson ; Go, Ronald S. ; Lin, Yi ; Russell, Stephen J ; Lust, John A. ; Zeldenrust, Steven R. ; Warsame, Rahma ; Hwa, Yi L. ; Hobbs, Miriam ; Fonder, Amie ; Kyle, Robert A. ; Rajkumar, S Vincent ; Kumar, Shaji K ; Gonsalves, Wilson. / Prognostic significance of circulating plasma cells by multi-parametric flow cytometry in light chain amyloidosis. In: Leukemia. 2018 ; Vol. 32, No. 6. pp. 1421-1426.
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abstract = "We evaluated the prognostic impact of clonal circulating plasma cells (cPCs) detected by six-color multi-parametric flow cytometry (MFC) in light chain (AL) amyloidosis at diagnosis. Of the 154 patients who underwent MFC, cPCs were detected in 42{\%} (n = 65) patients. Median number of cPCs was 81 per 150,000 events (range: 6-17,844). High bone marrow plasma cell percentage was an independent predictor of presence of cPCs. Presence of cPCs at diagnosis was associated with inferior overall survival (OS) (90 vs. 98 months, p = 0.003) and inferior progression free survival (PFS) (31 vs. 52 months, p = 0.02). Estimated 1, 2 and 5 year OS in the two groups was: 74, 64 and 57 and 89, 87, and 80{\%}, respectively. Estimated PFS at 1, 2, and 5 years was: 69, 56, and 23{\%} and 80, 74, and 37{\%}, respectively. Furthermore, the presence of cPCs at diagnosis was an independent adverse predictor of OS in multivariable analysis. Achieving a very-good partial response, or better, was able to overcome the adverse impact of cPCs at diagnosis. Patients with cPCs at diagnosis may warrant closer monitoring post-treatment, especially if they do not achieve a deep hematologic response.",
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AU - Sidana, Surbhi

AU - Tandon, Nidhi

AU - Dispenzieri, Angela

AU - Gertz, Morie

AU - Dingli, David M

AU - Jevremovic, Dragan

AU - Morice, William G.

AU - Kapoor, Prashant

AU - Kourelis, Taxiarchis

AU - Lacy, Martha

AU - Hayman, Suzanne R.

AU - Buadi, Francis K.

AU - Leung, Nelson

AU - Go, Ronald S.

AU - Lin, Yi

AU - Russell, Stephen J

AU - Lust, John A.

AU - Zeldenrust, Steven R.

AU - Warsame, Rahma

AU - Hwa, Yi L.

AU - Hobbs, Miriam

AU - Fonder, Amie

AU - Kyle, Robert A.

AU - Rajkumar, S Vincent

AU - Kumar, Shaji K

AU - Gonsalves, Wilson

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N2 - We evaluated the prognostic impact of clonal circulating plasma cells (cPCs) detected by six-color multi-parametric flow cytometry (MFC) in light chain (AL) amyloidosis at diagnosis. Of the 154 patients who underwent MFC, cPCs were detected in 42% (n = 65) patients. Median number of cPCs was 81 per 150,000 events (range: 6-17,844). High bone marrow plasma cell percentage was an independent predictor of presence of cPCs. Presence of cPCs at diagnosis was associated with inferior overall survival (OS) (90 vs. 98 months, p = 0.003) and inferior progression free survival (PFS) (31 vs. 52 months, p = 0.02). Estimated 1, 2 and 5 year OS in the two groups was: 74, 64 and 57 and 89, 87, and 80%, respectively. Estimated PFS at 1, 2, and 5 years was: 69, 56, and 23% and 80, 74, and 37%, respectively. Furthermore, the presence of cPCs at diagnosis was an independent adverse predictor of OS in multivariable analysis. Achieving a very-good partial response, or better, was able to overcome the adverse impact of cPCs at diagnosis. Patients with cPCs at diagnosis may warrant closer monitoring post-treatment, especially if they do not achieve a deep hematologic response.

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