Relationship Between Immunophenotype And Progression-free Survival In Multiple Myeloma

Objective: By collecting the abnormal plasma cell surface immunophenotype in bone marrow of multiple myeloma(MM)patients at newly diagnosis,we want to know the correlation between them and progression-free survival(PFS)and hope to provide reference for prognosis assessment,treatment and management of MM patients in clinical practice.Methods: Thirty-five progressive MM patients were collected who were admitted to the Department of Hematology of the First Affiliated Hospital of Wannan Medical College from October 2020 to December 2022.We need record the patients’ PFS and the immunophenotype of abnormal plasma cells in bone marrow of these patients that was detected by multiparameter flow cytometry(MFC)in our hospital at newly diagnosis.The correlation was evaluated between single/combined immunophenotype expression and patients’ PFS.Results: 1.Among the 35 newly diagnosed MM patients,there are 23 males and 12 females,aged from 42 to 77 years old,with a median age of 60 years old;PFS ranges from 6 to 59 months,with a median PFS of 20 months.Clinical manifestations at newly diagnosis: Among 35 patients,21 patients(60%)had bone pain,8 patients(22.86%)had anaemia,2 patients(5.71%)had renal failure,7 patients(20%)had other symptoms such as nose bleeding and digestive system symptoms,5 patients(14.29%)had no special discomfort(only abnormal laboratory indexes found in physical examinations).Clinical manifestations at the stage of progression: Among the 35 patients,8 patients(22.86%)had bone pain,4 patients(11.43%)had other symptoms such as anemia,nose bleeding and digestive system symptoms,and 23 patients(65.71%)had no special discomfort(only the higher abnormal laboratory indexes found in reexamination).2.Among 35 newly diagnosed MM patients,the negative expression rate of CD45 was 71.42%.The positive expression rate of CD138 was 68.57%.The positive expression rate of CD56 was 71.43%.The negative expression rate of CD19 was88.57%;The negative expression rate of CD28 was 62.86%.3.The median PFS at the age of less than 60 and more than 60 were 19 months and 21 months respectively,P=0.659 > 0.05.The one-year PFS were 82.4% and83.3% respectively,P=1 > 0.05.The two-year PFS were 17.6% and 44.4% respectively,P=0.146 > 0.05.The median PFS of male and female groups were 17 months and 23 months respectively,P=0.163 > 0.05.The one-year PFS were 78.3% and 91.7%respectively,P=0.64 > 0.05.The two-year PFS were 30.4% and 33.3% respectively,P=1 > 0.05.4.The median PFS of CD45-and CD45+ groups were 20 months and 19 months respectively,P=0.737 > 0.05.The one-year PFS were 84% and 80% respectively,P=1 > 0.05.The two-year PFS were 36% and 20% respectively,P=0.447 > 0.05.The median PFS of CD138+ and CD138-groups were 20 months and 16 months respectively,P=0.590 > 0.05.The one-year PFS were 79.2% and 90.9% respectively,P=0.640 > 0.05.The two-year PFS were 25% and 45.5% respectively,P=0.263 > 0.05.The median PFS of CD56+ and CD56-groups were 23 months and 11 months respectively,P=0.134 > 0.05.The one-year PFS were 96% and 50% respectively,P=0.004 < 0.05.The two-year PFS were 48% and 20% respectively,P=0.252 > 0.05.The median PFS of CD28-and CD28+ groups were 24 months and 18 months respectively,P=0.032 < 0.05.The one-year PFS were 90.9% and 69.2% respectively,P=0.166 > 0.05.The two-year PFS were 45.5% and 7.7% respectively,P=0.027 < 0.05.The median PFS of CD19-and CD19+ groups were 21 months and 11 months respectively,P=0.032 < 0.05.The one-year PFS were 90.3% and 25% respectively,P=0.011 < 0.05.The two-year PFS were 41.9% and 25% respectively,P=0.635 > 0.05.5.There were three patients with CD19+/CD56-,and the median PFS was 11 months.One patient was CD19+/CD56+ with PFS of 2 months.There were 7patients with CD19-/CD56-,and the median PFS was 16 months.There were 24 patients with CD19-/CD56+,and the median PFS was 22 months,P=0.001 < 0.05.Conclusion: The single and combined expression of flow immunophenotyping have a certain significance in predicting the PFS of MM patients,and it is necessary to combine with other laboratory indexes to screen high-risk patients.After that,it becomes more convenient for diagnosis,treatment and management.