Combined Measurement Of Immunophenotype And International Staging System In Multiple Myeloma Defines Patients With Good Or Poor Prognosis

Part One Combined measurement of immunophenotype and international staging system in multiple myeloma defines patients with good or poor prognosisObjective This study was purposed to investigate the immunophenotype characteristics,the clinical significance of CD28and International staging system in multiple myeloma(MM).Methods BM aspirate samples from49newly diagnosed MM patients and22patients after treatment were assessed using4color flow cytometric analyses.These MM patients were classified according to international staging system and the consolidated risk staging system.The survival rates and treatment efficiency of2staging system were compared.Results According to the international staging system,6cases of patients with multiple myeloma were stage Ⅰ,13cases were stage Ⅱ,and52cases were stage III. The higher stage, the lower treatment efficiency(83.3%vs38.5%vs36.5%),and the survival and progression-free survival time of High-risk group was significantly shortened(P<0.05). The rate of CD28abnormal expression has no significant difference between the initial and the treatment group,however, the survival and progression-free time and rate were significantly shorted in group of CD28+than the other ones (P<0.05). According to the consolidated risk staging system,46cases were high-risk group and25cases were low-risk group.In the aspects of remission rate, high-risk group contained less advantage than low ones,36.0%vs46.5%(X2=5.620, P<0.05),also in the aspects of2-year survival and1-year progression-free survival time and rate,18months vs53months,12.3%vs72.9%,41.1%vs77.7%(P<0.05).Conclusions These patients with higher ISS stage,abnormal expression of CD28,and high-risk group were related with poor prognosis. Part Two Clinical significance of BCL-6、 P53、 c-myc Aberrations in Diffuse Large B-cell LymphomaObjective: This study was purposed to investigate the detection of BCL-6, P53, c-myc aberrations in diffuse large B cell lymphoma (DLBCL) and its clinical significance.Methods:Interphase fluorescence in situ hybridization (I-FISH) was detected in59cases of DLBCL patients in vivo tissue BCL-6, P53protein, c-myc gene status. The patients were treated with CHOP or R-CHOP chemotherapy, and the survival rates and treatment efficiency were compared.Results:The p53deletion was detected in18of the59cases (30.5%), BCL-6rearrangement in11cases (18.6%),5cases with c-myc rearrangement (8.5%). In the aspects of remission rate, p53deletion positive group contained less advantage than negative ones,33.3%vs75.6%(^=9.560, P=0.002).The prognosis of BCL-6gene rearrangement positive group different from negative group, but the difference was not statistically significant (OS, P,=0.107; PFS P=0.094); p53deletion positive patients was in significantly worse prognosis than the negative group (OS, P,=0.031; PFS, P=0.028); c-myc rearrangement positive group difference in gene rearrangement negative group, but the difference was not statistically significant (OS P=0.163; PFS P=0.167). The CHOP group patients, prognosis of p53deletion, c-myc rearrangement positive group were significantly worse than the negative group, the difference was statistically significant (P <0.05); R-CHOP group, the prognostic significance of BCL-6gene rearrangement positive group were worse (OSP=0.003; PFS P=0.007). Conclusions:These DLBCL patients with BCL-6, P53, c-myc aberrations were related with poor prognosis. And them can be used as prognostic factors for predicting DLBCL and guiding therapy.