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Multiple Myeloma, Gammopathies

Quantification of circulating clonal plasma cells via multiparametric flow cytometry identifies patients with smoldering multiple myeloma at high risk of progression

Leukemia volume 31, pages 130–135 (2017)Cite this article

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Abstract

The presence of high numbers of circulating clonal plasma cells (cPCs) in patients with smoldering multiple myeloma (SMM), detected by a slide-based immunofluorescence assay, has been associated with a shorter time to progression (TTP) to MM. The significance of quantifying cPCs via multiparameter flow cytometry, a much more readily available diagnostic modality, in patients with SMM has not been evaluated. This study evaluated 100 patients with a known or new diagnosis of SMM who were seen at the Mayo Clinic, Rochester from January 2008 until December 2013. Patients with ⩾150 cPCs (N=9) were considered to have high number of cPCs based on the 97% specificity and 78% PPV of progression to MM within 2 years of cPC assessment. The median TTP of patients with ⩾150 cPCs was 9 months compared with not reached for patients with <150 cPCs (P<0.001). Thus, quantification of cPCs via multiparametric flow cytometry identifies patients with SMM at very high risk of progression to MM within 2 years and warrants confirmation in larger studies. In the future, this may allow reclassification of such patients as having MM requiring therapy prior to them enduring end-organ damage.

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Acknowledgements

This study is supported by Mayo Clinic Hematological Malignancies Program and in part by grants CA107476, CA62242, CA100707, CA168762 and CA83724 from the National Cancer Institute, Rockville, MD, USA. It is also supported in part by the Jabbs Foundation, Birmingham, UK and the Henry J. Predolin Foundation, USA, as well as the CTSA Grant UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Finally, the Marion Schwarz Foundation for Multiple Myeloma has also provided support for this study.

Author contributions

SKK, SVR and WIG designed the study and analyzed the data and wrote the manuscript; MAG, AD, MQL, WGM, MMT, FKB, DD, RSG, SRH, JAL, NL, RAK, SRZ, SJR and PK contributed to writing and reviewing the manuscript.

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Authors and Affiliations

  1. The Divisions of Hematology and Blood and Marrow Transplantation, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    W I Gonsalves, S V Rajkumar, A Dispenzieri, D Dingli, M M Timm, W G Morice, M Q Lacy, F K Buadi, R S Go, N Leung, P Kapoor, S R Hayman, J A Lust, S J Russell, S R Zeldenrust, L Hwa, T V Kourelis, R A Kyle, M A Gertz & S K Kumar

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  1. W I Gonsalves
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  2. S V Rajkumar
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  18. R A Kyle
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  20. S K Kumar
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Corresponding author

Correspondence to S K Kumar.

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Supplementary Information accompanies this paper on the Leukemia website

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Gonsalves, W., Rajkumar, S., Dispenzieri, A. et al. Quantification of circulating clonal plasma cells via multiparametric flow cytometry identifies patients with smoldering multiple myeloma at high risk of progression. Leukemia 31, 130–135 (2017). https://doi.org/10.1038/leu.2016.205

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