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Blood, 1 October 2005, Vol. 106, No. 7, pp. 2276-2279.
Prepublished online as a Blood First Edition Paper on June 16, 2005; DOI 10.1182/blood-2005-05-1858.
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Submitted May 9, 2005
Accepted May 31, 2005
Circulating plasma cells detected by flow cytometry as a predictor of survival in 302 patients with newly diagnosed multiple myeloma
Grzegorz S Nowakowski, Thomas E Witzig, David Dingli, Michal J Tracz, Morie A Gertz, Martha Q Lacy, John A Lust, Angela Dispenzieri, Philip R Greipp, Robert A Kyle, and S V Rajkumar*
Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
* Corresponding author; email: rajkumar.vincent{at}mayo.edu.
We detected circulating PC by flow cytometry in 302 patients with newly diagnosed MM by gating on CD38+ CD45- cells. The number of circulating PC per 50,000 mononuclear cells was reported. In 80 patients (27%) no circulating PC were seen; 106 (35%) patients had 1-10 and 115 (38%) patients had more than 10 circulating PC. Median overall survival for the all 302 patients was 47 months. Patients with 10 or less circulating PC had a median survival of 58.7 months, while patients with more than 10 circulating PC had a median survival of 37.3 months (p=0.0044). On multivariate analysis, the prognostic value of circulating PC was independent of beta2-microglobulin, albumin, and C-reactive protein. There was only a weak correlation between tumor mass and circulating PC, suggesting that appearance of circulating PC may be a reflection of tumor biology. We conclude that the number of circulating PC measured by flow cytometry in patients with newly diagnosed MM is an independent predictor of survival.
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