TY - JOUR
T1 - Prognostic significance of circulating plasma cells by multi-parametric flow cytometry in light chain amyloidosis
AU - Sidana, Surbhi
AU - Tandon, Nidhi
AU - Dispenzieri, Angela
AU - Gertz, Morie A.
AU - Dingli, David
AU - Jevremovic, Dragan
AU - Morice, William G.
AU - Kapoor, Prashant
AU - Kourelis, Taxiarchis V.
AU - Lacy, Martha Q.
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 I.
N1 - Publisher Copyright:
© 2018 Macmillan Publishers Limited, part of Springer Nature.
PY - 2018/6/1
Y1 - 2018/6/1
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.
AB - 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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U2 - 10.1038/s41375-018-0063-7
DO - 10.1038/s41375-018-0063-7
M3 - Article
C2 - 29483709
AN - SCOPUS:85042532274
SN - 0887-6924
VL - 32
SP - 1421
EP - 1426
JO - Leukemia
JF - Leukemia
IS - 6
ER -