ASH 2022 | The prognostic impact of circulating plasma cells in patients with multiple myeloma
Evangelos Terpos, MD, PhD, National and Kapodistrian University of Athens, Athens, Greece, outlines findings from a study that evaluated the presence of circulating tumor cells (CTCs) in patients with newly diagnosed multiple myeloma utilizing next-generation flow cytometry. Overall, compared to bone marrow clonal cells, the study found that increased peripheral blood CTCs was independently associated with poor prognosis. A sub-analysis also found that CTCs correlated strongly with high-risk cytogenetics. This interview took place at the 64th ASH Annual Meeting and Exposition congress in New Orleans, LA.
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Transcript (edited for clarity)
I think that this is an important paper because we have the two or three recent publications from the Spanish, the Italian, and the Dutch Group, suggesting that circulating plasma cells have a prognostic impact.
So what we did in this specific abstract was that first of all, we compared the bone marrow with the peripheral blood circulating tumor cells, and we’ve seen that we have almost 90% of concordance...
I think that this is an important paper because we have the two or three recent publications from the Spanish, the Italian, and the Dutch Group, suggesting that circulating plasma cells have a prognostic impact.
So what we did in this specific abstract was that first of all, we compared the bone marrow with the peripheral blood circulating tumor cells, and we’ve seen that we have almost 90% of concordance. And the second is that with a median of 0.01% of the circulating plasma cell, we established the level of 0.02% that had prognostic significance for both patients who received the transplant, and for those who did not receive a transplant.
And interestingly, because the majority of the other publications who are focused on patients who received the transplant in a clinical trial, in our paper, all these patients were treated in a real world. So not participating in a clinical trial. And we’ve seen that, especially the patients who were ineligible for transplant, the circulating plasma cell at the level of 0.02% was an independent prognostic factor for survival, and I think that this is extremely important.
Then we had a specific subanalysis, and we’ve seen that the circulating plasma cells correlate very nicely with a high-risk cytogenetics. So in high-risk cytogenetics, patients have a higher number of circulating plasma cells, and also the level of 0.02% could differentiate the overall survival in international staging system 2 patients, that I think that this is also extremely important.
So in general, we’ve seen that we are able, with using the Euroflow, next-generation flow cytometry method, to first of all check the number of peripheral tumor cells in the blood in patients with multiple myeloma, and to establish a level of 0.02% that has independent prognostic value.
I want to mention that this is in accordance to the Bruno Paiva group full paper that was published in the Journal of Clinical Oncology, that the level of 0.01% had an independent prognostic value for survival. And we have used the same methodology, so I believe that the two cutoff levels are very close to each other.
So I believe that all these groups have to collaborate with each other in order to find out, which is the best methodology, and which is the best cutoff for the prognostic value, in order to have a more recommended cutoff in future guidelines.
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Disclosures
GSK: Honoraria, Research Funding; BMS: Honoraria; EUSA Pharma: Honoraria, Other: Travel expenses; Amgen: Honoraria, Other: Travel expenses, Research Funding; Sanofi: Honoraria, Research Funding; Takeda: Honoraria, Other: Travel expenses, Research Funding; Genesis: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Novartis: Honoraria.
