Quantification of circulating clonal plasma cells via multiparametric flow cytometry identifies patients with smoldering multiple myeloma at high risk of progression

Wilson Gonsalves, S Vincent Rajkumar, Angela Dispenzieri, David M Dingli, M. M. Timm, W. G. Morice, Martha Lacy, F. K. Buadi, R. S. Go, N. Leung, Prashant Kapoor, S. R. Hayman, J. A. Lust, Stephen J Russell, S. R. Zeldenrust, L. Hwa, Taxiarchis Kourelis, R. A. Kyle, Morie Gertz, Shaji K Kumar

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Abstract

The presence of high numbers of circulating clonal plasma cells (cPCs) in patients with smoldering multiple myeloma (SMM), detected by a slide-based immunofluorescence assay, has been associated with a shorter time to progression (TTP) to MM. The significance of quantifying cPCs via multiparameter flow cytometry, a much more readily available diagnostic modality, in patients with SMM has not been evaluated. This study evaluated 100 patients with a known or new diagnosis of SMM who were seen at the Mayo Clinic, Rochester from January 2008 until December 2013. Patients with ⩾150 cPCs (N=9) were considered to have high number of cPCs based on the 97% specificity and 78% PPV of progression to MM within 2 years of cPC assessment. The median TTP of patients with ⩾150 cPCs was 9 months compared with not reached for patients with <150 cPCs (P<0.001). Thus, quantification of cPCs via multiparametric flow cytometry identifies patients with SMM at very high risk of progression to MM within 2 years and warrants confirmation in larger studies. In the future, this may allow reclassification of such patients as having MM requiring therapy prior to them enduring end-organ damage.Leukemia advance online publication, 26 August 2016; doi:10.1038/leu.2016.205.

Original languageEnglish (US)
JournalLeukemia
DOIs
StateAccepted/In press - Aug 26 2016

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Plasma Cells
Multiple Myeloma
Flow Cytometry
Fluorescent Antibody Technique
Publications
Leukemia

ASJC Scopus subject areas

  • Medicine(all)
  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

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title = "Quantification of circulating clonal plasma cells via multiparametric flow cytometry identifies patients with smoldering multiple myeloma at high risk of progression",
abstract = "The presence of high numbers of circulating clonal plasma cells (cPCs) in patients with smoldering multiple myeloma (SMM), detected by a slide-based immunofluorescence assay, has been associated with a shorter time to progression (TTP) to MM. The significance of quantifying cPCs via multiparameter flow cytometry, a much more readily available diagnostic modality, in patients with SMM has not been evaluated. This study evaluated 100 patients with a known or new diagnosis of SMM who were seen at the Mayo Clinic, Rochester from January 2008 until December 2013. Patients with ⩾150 cPCs (N=9) were considered to have high number of cPCs based on the 97{\%} specificity and 78{\%} PPV of progression to MM within 2 years of cPC assessment. The median TTP of patients with ⩾150 cPCs was 9 months compared with not reached for patients with <150 cPCs (P<0.001). Thus, quantification of cPCs via multiparametric flow cytometry identifies patients with SMM at very high risk of progression to MM within 2 years and warrants confirmation in larger studies. In the future, this may allow reclassification of such patients as having MM requiring therapy prior to them enduring end-organ damage.Leukemia advance online publication, 26 August 2016; doi:10.1038/leu.2016.205.",
author = "Wilson Gonsalves and Rajkumar, {S Vincent} and Angela Dispenzieri and Dingli, {David M} and Timm, {M. M.} and Morice, {W. G.} and Martha Lacy and Buadi, {F. K.} and Go, {R. S.} and N. Leung and Prashant Kapoor and Hayman, {S. R.} and Lust, {J. A.} and Russell, {Stephen J} and Zeldenrust, {S. R.} and L. Hwa and Taxiarchis Kourelis and Kyle, {R. A.} and Morie Gertz and Kumar, {Shaji K}",
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T1 - Quantification of circulating clonal plasma cells via multiparametric flow cytometry identifies patients with smoldering multiple myeloma at high risk of progression

AU - Gonsalves, Wilson

AU - Rajkumar, S Vincent

AU - Dispenzieri, Angela

AU - Dingli, David M

AU - Timm, M. M.

AU - Morice, W. G.

AU - Lacy, Martha

AU - Buadi, F. K.

AU - Go, R. S.

AU - Leung, N.

AU - Kapoor, Prashant

AU - Hayman, S. R.

AU - Lust, J. A.

AU - Russell, Stephen J

AU - Zeldenrust, S. R.

AU - Hwa, L.

AU - Kourelis, Taxiarchis

AU - Kyle, R. A.

AU - Gertz, Morie

AU - Kumar, Shaji K

PY - 2016/8/26

Y1 - 2016/8/26

N2 - The presence of high numbers of circulating clonal plasma cells (cPCs) in patients with smoldering multiple myeloma (SMM), detected by a slide-based immunofluorescence assay, has been associated with a shorter time to progression (TTP) to MM. The significance of quantifying cPCs via multiparameter flow cytometry, a much more readily available diagnostic modality, in patients with SMM has not been evaluated. This study evaluated 100 patients with a known or new diagnosis of SMM who were seen at the Mayo Clinic, Rochester from January 2008 until December 2013. Patients with ⩾150 cPCs (N=9) were considered to have high number of cPCs based on the 97% specificity and 78% PPV of progression to MM within 2 years of cPC assessment. The median TTP of patients with ⩾150 cPCs was 9 months compared with not reached for patients with <150 cPCs (P<0.001). Thus, quantification of cPCs via multiparametric flow cytometry identifies patients with SMM at very high risk of progression to MM within 2 years and warrants confirmation in larger studies. In the future, this may allow reclassification of such patients as having MM requiring therapy prior to them enduring end-organ damage.Leukemia advance online publication, 26 August 2016; doi:10.1038/leu.2016.205.

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