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Plasma cell proliferative index post-transplant is a powerful predictor of prognosis in myeloma patients failing to achieve a complete response

Bone Marrow Transplantation volume 54, pages 442–447 (2019)Cite this article

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Abstract

Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI). The remaining 40% (n = 152) of patients had PCPI performed with 79% (n = 120) having a low PCPI and 21% (n = 32) having an elevated PCPI. Patients with an elevated PCPI had significantly shorter progression free and overall survival. The median PFS was 8 months for elevated PCPI vs. 19 months for low PCPI vs. 24 months for no PCPI (p < 0.0001). The median OS was 27 months for elevated PCPI vs. 79 months for low PCPI vs. not reached for no PCPI, p < 0.0001). On multivariable analysis post-therapy PCPI was an independent predictor of progression free and overall survival. The PCPI post-therapy is a powerful predictor of survival and risk stratifies myeloma patients failing to achieve complete response early in the disease course.

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    Authors and Affiliations

    1. Division of Hematology, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, USA

      M Hasib Sidiqi, Mohammed A. Aljama, Francis K. Buadi, Rahma Warsame, Martha Q. Lacy, Angela Dispenzieri, David Dingli, Wilson I. Gonsalves, Shaji Kumar, Prashant Kapoor, Taxiarchis Kourelis, William J. Hogan, Eli Muchtar, John A. Lust, Vincent S. Rajkumar & Morie A. Gertz

    2. Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, USA

      Dragan Jevremovic, William G. Morice & Michael Timm

    3. Division of Nephrology and Hypertension, Mayo Clinic Rochester, Rochester, USA

      Nelson Leung

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    Correspondence to Morie A. Gertz.

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    These authors contributed equally: M. Hasib Sidiqi, Mohammed Aljama.

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    Sidiqi, M.H., Aljama, M.A., Jevremovic, D. et al. Plasma cell proliferative index post-transplant is a powerful predictor of prognosis in myeloma patients failing to achieve a complete response. Bone Marrow Transplant 54, 442–447 (2019). https://doi.org/10.1038/s41409-018-0280-8

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