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Blood, 15 April 2006, Vol. 107, No. 8, pp. 3384-3388. Prepublished online as a Blood First Edition Paper on December 8, 2005; DOI 10.1182/blood-2005-08-3398. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-08-3398v1 107/8/3384    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dingli, D. Articles by Gertz, M. A. Search for Related Content PubMed PubMed Citation Articles by Dingli, D. Articles by Gertz, M. A. Related Collections Transplantation Clinical Trials and Observations Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Flow cytometric detection of circulating myeloma cells before transplantation in patients with multiple myeloma: a simple risk stratification system David Dingli, Grzegorz S. Nowakowski, Angela Dispenzieri, Martha Q. Lacy, Suzanne R. Hayman, S. Vincent Rajkumar, Philip R. Greipp, Mark R. Litzow, Dennis A. Gastineau, Thomas E. Witzig, and Morie A. Gertz From the Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN. Detection of circulating myeloma cells (CMCs) by flow cytometry in patients with multiple myeloma (MM) indicates active disease. We hypothesized that detection of CMCs at the time of stem-cell collection prior to autologous stem-cell transplantation (ASCT) identifies patients at high risk of rapid progression. A cohort of patients undergoing ASCT was identified. CMCs were determined by gating on CD38+/CD45- cells using flow cytometry. The impact of CMCs on overall survival (OS) and time to progression (TTP) was evaluated in univariate and multivariate analyses. Of 246 patients undergoing ASCT, 95 had CMCs. Complete response (CR) rates after transplantation were 32% and 36% for patients with and without CMCs, respectively (P = .50). OSs were 33.2 and 58.6 months (P = .01) whereas TTPs were 14.1 and 22 months, respectively (P = .001). On multivariate analysis, CMCs remained independent of cytogenetics and disease status at time of transplantation (P = .03). CMCs and cytogenetics were combined in a new scoring system. Patients with neither, one, or both parameters had a median OS of 55, 48, and 21.5 months and a median TTP of 22, 15.4, and 6.5 months, respectively. CMCs at the time of ASCT is an independent prognostic factor and in combination with cytogenetics provides a powerful scoring system that stratifies patients and guides management. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. O. Abdalla, P. Kokhaei, L. Hansson, H. Mellstedt, and A. Osterborg Idiotype vaccination in patients with myeloma reduced circulating myeloma cells (CMC) Ann. Onc., June 1, 2008; 19(6): 1172 - 1179. [Abstract] [Full Text] [PDF] F. E. Craig and K. A. Foon Flow cytometric immunophenotyping for hematologic neoplasms Blood, April 15, 2008; 111(8): 3941 - 3967. [Abstract] [Full Text] [PDF] E. Perez-Persona, M.-B. Vidriales, G. Mateo, R. Garcia-Sanz, M.-V. Mateos, A. G. de Coca, J. Galende, G. Martin-Nunez, J. M. Alonso, N. de las Heras, et al. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells Blood, October 1, 2007; 110(7): 2586 - 2592. [Abstract] [Full Text] [PDF]

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