MULTIPARAMETRIC FLOW CYTOMETRY REFINES RISK STRATIFICATION IN NEWLY DIAGNOSED MULTIPLE MYELOMA PATIENTS

Main Article Content

Francesca Fazio
Gianfranco Lapietra
Maria Zaira Limongi
Stefania Intoppa
Maria Laura Milani
Alfonso Piciocchi
Maurizio Martelli
Anna Guarini
Robin Foà
Maria Stefania De Propris
Maria Teresa Petrucci

Keywords

Flow Cytometry, multiple myeloma, cytogenetics, I-FISH, survival, karyotype

Abstract

Multiple myeloma (MM) is a heterogeneous malignancy characterized by the proliferation of abnormal plasma cells in the bone marrow. Multiparametric flow cytometry (MFC) plays a role in the work-up of the disease in view of the aberrant expression of surface antigens. Our study aimed at describing the antigenic profile detected by MFC in a series of newly diagnosed MM patients to correlate the level of expression with other features of the disease. Between April 2018 and June 2022, 84 consecutive MM patients were studied at presentation. CD56 and CD117 were commonly detected, while CD45, CD28, CD20, CD19, CD13 and CD33 were less recurrent. CD20 expression was associated with the type of secretory MM (p=0.041) and with a higher disease burden (p=0.038). CD28 positivity correlated with a lower platelet count at baseline (p=0.005) and with a lower rate of complete response (p=0.038). Furthermore, CD28 positivity and a lower CD138 expression tended to associate with the high-risk chromosomal translocations t(14;16) and t(4;14). The results of this study indicate that in the diagnostic work-up of MM, MFC may help to identify different patient subsets and improve risk stratification. These observations need to be validated in larger series of patients with a longer follow-up.

Downloads

Download data is not yet available.


Abstract 378
PDF Downloads 386
HTML Downloads 94

References

1. Rawstron AC, Orfao A, Beksac M, Bezdickova L, Brooimans RA, Bumbea H, Dalva K, Fuhler G, Gratama J, Hose D, Kovarova L, Lioznov M, Mateo G, Morilla R, Mylin AK, Omedé P, Pellat-Deceunynck C, Perez Andres M, Petrucci M, Ruggeri M, Rymkiewicz G, Schmitz A, Schreder M, Seynaeve C, Spacek M, de Tute RM, Van Valckenborgh E, Weston-Bell N, Owen RG, San Miguel JF, Sonneveld P, Johnsen HE; European Myeloma Network. Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders. Haematologica. 2008 Mar;93(3):431-8. DOI: 10.3324/haematol.11080
2. Flores-Montero J, de Tute R, Paiva B, Perez JJ, Böttcher S, Wind H, Sanoja L, Puig N, Lecrevisse Q, Vidriales MB, van Dongen JJ, Orfao A. Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma. Cytometry B Clin Cytom. 2016 Jan;90(1):61-72. DOI: 10.1002/cyto.b.21265
3. Paiva B, Almeida J, Pérez-Andrés M, Mateo G, López A, Rasillo A, Vídriales MB, López-Berges MC, Miguel JF, Orfao A. Utility of flow cytometry immunophenotyping in multiple myeloma and other clonal plasma cell-related disorders. Cytometry B Clin Cytom. 2010 Jul;78(4):239-52. DOI: 10.1002/cyto.b.20512
4. Courville EL, Yohe S, Shivers P, Linden MA. VS38 identifies myeloma cells with dim CD38 expression and plasma cells following daratumumab therapy, which interferes with CD38 detection for 4 to 6 months. Am J Clin Pathol. 2020 Jan 2;153(2):221-228. DOI: 10.1093/ajcp/aqz153
5. Paiva B, Vidriales MB, Pérez JJ, Mateo G, Montalbán MA, Mateos MV, Bladé J, Lahuerta JJ, Orfao A, San Miguel JF; GEM (Grupo Español de MM) cooperative study group; PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) cooperative study group. Multiparameter flow cytometry quantification of bone marrow plasma cells at diagnosis provides more prognostic information than morphological assessment in myeloma patients. Haematologica. 2009 Nov;94(11):1599-602. DOI: 10.3324/haematol.2009.009100
6. Bataille R, Jégo G, Robillard N, Barillé-Nion S, Harousseau JL, Moreau P, Amiot M, Pellat-Deceunynck C. The phenotype of normal, reactive and malignant plasma cells. Identification of "many and multiple myelomas" and of new targets for myeloma therapy. Haematologica. 2006 Sep;91(9):1234-40.
7. Mateo G, Montalbán MA, Vidriales MB, Lahuerta JJ, Mateos MV, Gutiérrez N, Rosiñol L, Montejano L, Bladé J, Martínez R, de la Rubia J, Diaz-Mediavilla J, Sureda A, Ribera JM, Ojanguren JM, de Arriba F, Palomera L, Terol MJ, Orfao A, San Miguel JF; PETHEMA Study Group; GEM Study Group. Prognostic value of immunophenotyping in multiple myeloma: a study by the PETHEMA/GEM cooperative study groups on patients uniformly treated with high-dose therapy. J Clin Oncol. 2008 Jun 1;26(16):2737-44. DOI: 10.1200/JCO.2007.15.4120
8. Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, Richardson P, Caltagirone S, Lahuerta JJ, Facon T, Bringhen S, Gay F, Attal M, Passera R, Spencer A, Offidani M, Kumar S, Musto P, Lonial S, Petrucci MT, Orlowski RZ, Zamagni E, Morgan G, Dimopoulos MA, Durie BG, Anderson KC, Sonneveld P, San Miguel J, Cavo M, Rajkumar SV, Moreau P. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015 Sep 10;33(26):2863-9. DOI: 10.1200/JCO.2015.61.2267
9. Bahlis NJ, King AM, Kolonias D, Carlson LM, Liu HY, Hussein MA, Terebelo HR, Byrne GE Jr, Levine BL, Boise LH, Lee KP. CD28-mediated regulation of multiple myeloma cell proliferation and survival. Blood. 2007 Jun 1;109(11):5002-10. DOI: 10.1182/blood-2006-03-012542
10. Koumpis E, Tassi I, Malea T, Papathanasiou K, Papakonstantinou I, Serpanou A, Tsolas E, Kapsali E, Vassilakopoulos TP, Papoudou-Bai A, Hatzimichael E. CD56 expression in multiple myeloma: Correlation with poor prognostic markers but no effect on outcome. Pathol Res Pract. 2021 Sep;225:153567. DOI: 10.1016/j.prp.2021.153567
11. Abdallah N, Rajkumar SV, Greipp P, Kapoor P, Gertz MA, Dispenzieri A, Baughn LB, Lacy MQ, Hayman SR, Buadi FK, Dingli D, Go RS, Hwa YL, Fonder A, Hobbs M, Lin Y, Leung N, Kourelis T, Warsame R, Siddiqui M, Lust J, Kyle RA, Bergsagel L, Ketterling R, Kumar SK. Cytogenetic abnormalities in multiple myeloma: association with disease characteristics and treatment response. Blood Cancer J. 2020 Aug 11;10(8):82. DOI: 10.1038/s41408-020-00348-5
12. Aref S, Goda T, El-Sherbiny M. Syndecan-1 in multiple myeloma: relationship to conventional prognostic factors. Hematology. 2003 Aug;8(4):221-8. DOI: 10.1080/1024533031000153630