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Gonzalez-Montes Y, Osca-Gelis G, Rodriguez-Romanos R, Villavicencio A, González-Bártulos M, Llopis F, Clapes V, Oriol A, Sureda A, Escoda L, Sarrà J, Garzó A, Lloveras N, Gómez B, Granada I, Gallardo D. CD200 genotype is associated with clinical outcome of patients with multiple myeloma. Front Immunol 2024; 15:1252445. [PMID: 38455039 PMCID: PMC10917927 DOI: 10.3389/fimmu.2024.1252445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/30/2024] [Indexed: 03/09/2024] Open
Abstract
Immune dysfunction in patients with MM affects both the innate and adaptive immune system. Molecules involved in the immune response pathways are essential to determine the ability of cancer cells to escape from the immune system surveillance. However, few data are available concerning the role of immune checkpoint molecules in predicting the myeloma control and immunological scape as mechanism of disease progression. We retrospectively analyzed the clinical impact of the CD200 genotype (rs1131199 and rs2272022) in 291 patients with newly diagnosed MM. Patients with a CD200 rs1131199 GG genotype showed a median overall survival (OS) significantly lower than those with CC+CG genotype (67.8 months versus 94.4 months respectively; p: 0.022) maintaining significance in the multivariate analysis. This effect was specially detected in patients not receiving an autologous stem cell transplant (auto-SCT) (p < 0.001). In these patients the rs1131199 GG genotype negatively influenced in the mortality not related with the progression of MM (p: 0.02) mainly due to infections events.
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Affiliation(s)
- Yolanda Gonzalez-Montes
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Gemma Osca-Gelis
- Hospital Cancer Registry Unit, Catalan Institute of Oncology, Girona, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Girona, Spain
- Center CIBER of Epidemiology and Public Health (CIBERESP), Girona, Spain
| | - Rocío Rodriguez-Romanos
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Alicia Villavicencio
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Marta González-Bártulos
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Francesca Llopis
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Victòria Clapes
- Clinical Hematology Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Institut d’Investigaciò Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Albert Oriol
- Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Barcelona, Spain
| | - Anna Sureda
- Clinical Hematology Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Institut d’Investigaciò Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, Barcelona, Spain
| | - Lourdes Escoda
- Hematology Department, Institut Català d’Oncologia, Hospital Joan XXIII, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Josep Sarrà
- Hematology Department, Institut Català d’Oncologia, Hospital Joan XXIII, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Ana Garzó
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Natàlia Lloveras
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Beatriz Gómez
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
| | - Isabel Granada
- Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Barcelona, Spain
| | - David Gallardo
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Universitat de Girona, Girona, Spain
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2
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Wang J, Li J, Zhang R, Li J, Chen L, Jin Y. Real-world prognostic significance of attaining minimal residual disease negativity in newly diagnosed multiple myeloma. Discov Oncol 2024; 15:38. [PMID: 38367151 PMCID: PMC10874347 DOI: 10.1007/s12672-024-00891-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/11/2024] [Indexed: 02/19/2024] Open
Abstract
The aim of the study was to evaluate the prognostic impact of minimal residual disease (MRD) in the real-world setting and the interaction between MRD and molecular risk, clinical response and autologous stem-cell transplant (ASCT). A retrospective analysis of 275 newly diagnosed multiple myeloma (NDMM) patients who achieved very good partial remission (VGPR) or better before maintenance were involved. We examined MRD status by multiparameter flow cytometry (MFC). At a median follow-up of 37 months (4-88 months), In patients who achieved ≥ VGPR, those with MRD negativity had significantly longer PFS (51 vs. 26 months; P < 0.001) and OS (Not reached: NR vs. 62 months, P < 0.001) than those with MRD positivity. MRD positivity was the independent prognostic factor for PFS with hazard ratios of 2.650 (95% CI 1.755-4.033, P < 0.001) and OS with hazard ratios of 2.122 (95% CI 1.155-3.899, P = 0.015). Achieving MRD negativity was able to ameliorate a poor prognosis associated with genetic high risk. MRD negativity was associated with better PFS regardless of ASCT treatment. MRD status was more predictable for clinical outcome than conventional clinical responses. Moreover, Sustained MRD negativity ≥ 12 or ≥ 24 months improved both PFS and OS. Patients with NDMM who achieved MRD-negative status or sustained MRD negativity had deep remission and improved clinical outcomes regardless of high-risk cytogenetics, ASCT and clinical responses in a real-world setting.
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Affiliation(s)
- Jing Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jing Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Run Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jianyong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Lijuan Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China.
| | - Yuanyuan Jin
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, No. 300 Guangzhou Road, Nanjing, 210029, China.
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Belotti A, Ribolla R, Crippa C, Chiarini M, Giustini V, Ferrari S, Peli A, Cattaneo C, Roccaro A, Frittoli B, Grazioli L, Rossi G, Tucci A. Predictive role of sustained imaging MRD negativity assessed by diffusion-weighted whole-body MRI in multiple myeloma. Am J Hematol 2023; 98:E230-E232. [PMID: 37317959 DOI: 10.1002/ajh.26995] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/30/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Angelo Belotti
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | | | - Claudia Crippa
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Marco Chiarini
- Clinical Chemistry Laboratory/Diagnostic Department, ASST Spedali Civili, Brescia, Italy
| | - Viviana Giustini
- Clinical Chemistry Laboratory/Diagnostic Department, ASST Spedali Civili, Brescia, Italy
| | | | - Annalisa Peli
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Chiara Cattaneo
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Aldo Roccaro
- Clinical Trial Center, Translational Research and Phase I Unit, ASST Spedali Civili, Brescia, Italy
| | | | - Luigi Grazioli
- Department of Radiology, ASST Spedali Civili, Brescia, Italy
| | - Giuseppe Rossi
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
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Alhuraiji A, Abd El Razik D, A.A. Elkourahy Omar S. Treatment of Multiple Myeloma in the First Relapse. RECENT UPDATES ON MULTIPLE MYELOMA 2023. [DOI: 10.5772/intechopen.106895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The treatment scope for relapsed myeloma has been expanded considerably in the last few years, by virtue of the advent of numerous novel agents with new mechanisms of actions. This has resulted in increasing responses and prolonging survival even in advanced diseases. The wealth of novel regimens comes with the challenges of balancing toxicities and aligning a regimen with the biology of myeloma and the nature of relapse in conjunction with the patient’s treatment history, comorbidities, and personal preference. The second-line treatment in myeloma includes new generation of proteasome inhibitors and immunomodulators, CD38 monoclonal antibodies, Panobinostat, and Elotuzumab. Recent randomized trials have shown that triplet combinations incorporating CD38 monoclonal antibodies, dexamethasone along with either proteasome inhibitor or immunomodulator were superior to doublet combinations in terms of response rate and progression-free survival. The choice of the second-line therapy is determined by lenalidomide/bortezomib exposure and resistance and access to new agents. Furthermore, autologous transplantation should be considered in selected cases. Here, we will be discussing the optimal management of multiple myeloma in the first relapse.
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Gonzalez-Montes Y, Rodriguez-Romanos R, Villavicencio A, Osca-Gelis G, González-Bártulos M, Llopis F, Clapes V, Oriol A, Sureda A, Escoda L, Sarrà J, Garzó A, Lloveras N, Díez I, Granada I, Gallardo D. Genetic variants of CTLA4 are associated with clinical outcome of patients with multiple myeloma. Front Immunol 2023; 14:1158105. [PMID: 37122695 PMCID: PMC10143497 DOI: 10.3389/fimmu.2023.1158105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Immune dysfunction in patients with multiple myeloma (MM) affects both the innate and adaptive immune system. Molecules involved in the immune checkpoint pathways are essential to determine the ability of cancer cells to escape from the immune system surveillance. However, few data are available concerning the role of these molecules in predicting the kinetics of progression of MM. We retrospectively analysed polymorphisms of CTLA4 (rs231775 and rs733618), BTLA (rs9288953), CD28 (rs3116496), PD-1 (rs36084323 and rs11568821) and LAG-3 (rs870849) genes in 239 patients with newly diagnosed MM. Patients with a CTLA4 rs231775 AA/AG genotype showed a median progression-free survival (PFS) significantly lower than those with GG genotype (32.3 months versus 96.8 months respectively; p: 0.008). The 5-year PFS rate was 25% for patients with grouped AA and AG genotype vs 55.4% for patients with GG genotype. Multivariate analysis confirmed the CTLA4 rs231775 genotype as an independent risk factor for PFS (Hazard Ratio (HR): 2.05; 95% CI: 1.0-6.2; p: 0.047). Our results suggest that the CTLA4 genotype may identify patients with earlier progression of MM. This polymorphism could potentially be used as a prognostic biomarker.
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Affiliation(s)
- Yolanda Gonzalez-Montes
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
- *Correspondence: Yolanda Gonzalez-Montes,
| | - Rocío Rodriguez-Romanos
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Alicia Villavicencio
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Gemma Osca-Gelis
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
- Girona Cancer Registry, Oncology Coordination Plan, Catalan Institute of Oncology (RTH) ICO-ICS, Centre CIBER of Epidemiology and Public Health (CIBERESP), Girona, Spain
| | - Marta González-Bártulos
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Francesca Llopis
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Victòria Clapes
- Clinical Hematology Department, Institut Català d’Oncologia, L’Hospitalet, IDIBELL, Universitat de Barcelona, Hospitalet de LLobregat, Spain
| | - Albert Oriol
- Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Barcelona, Spain
| | - Anna Sureda
- Clinical Hematology Department, Institut Català d’Oncologia, L’Hospitalet, IDIBELL, Universitat de Barcelona, Hospitalet de LLobregat, Spain
| | - Lourdes Escoda
- Hematology Department, Institut Català d’Oncologia, Hospital Joan XXIII, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Josep Sarrà
- Hematology Department, Institut Català d’Oncologia, Hospital Joan XXIII, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Ana Garzó
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Natàlia Lloveras
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Isabel Díez
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
| | - Isabel Granada
- Hematology Department, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Barcelona, Spain
| | - David Gallardo
- Hematology Department, Institut Català d’Oncologia, Hospital Dr. Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Josep Carreras Research Institute, Girona, Universitat de Girona, Girona, Spain
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Bonello F, Cani L, D'Agostino M. Risk Stratification Before and During Treatment in Newly Diagnosed Multiple Myeloma: From Clinical Trials to the Real-World Setting. Front Oncol 2022; 12:830922. [PMID: 35356221 PMCID: PMC8959380 DOI: 10.3389/fonc.2022.830922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/08/2022] [Indexed: 12/22/2022] Open
Abstract
Multiple Myeloma (MM) is a hematologic malignancy characterized by a wide clinical and biological heterogeneity leading to different patient outcomes. Various prognostic tools to stratify newly diagnosed (ND)MM patients into different risk groups have been proposed. At baseline, the standard-of-care prognostic score is the Revised International Staging System (R-ISS), which stratifies patients according to widely available serum markers (i.e., albumin, β 2-microglobulin, lactate dehydrogenase) and high-risk cytogenetic abnormalities detected by fluorescence in situ hybridization. Though this score clearly identifies a low-risk and a high-risk population, the majority of patients are categorized as at “intermediate risk”. Although new prognostic factors identified through molecular assays (e.g., gene expression profiling, next-generation sequencing) are now available and may improve risk stratification, the majority of them need specialized centers and bioinformatic expertise that may preclude their broad application in the real-world setting. In the last years, new tools to monitor response and measurable residual disease (MRD) with very high sensitivity after the start of treatment have been developed. MRD analyses both inside and outside the bone marrow have a strong prognostic impact, and the achievement of MRD negativity may counterbalance the high-risk behavior identified at baseline. All these techniques have been developed in clinical trials. However, their efficient application in real-world clinical practice and their potential role to guide treatment-decision making are still open issues. This mini review will cover currently known prognostic factors identified before and during first-line treatment, with a particular focus on their potential applications in real-world clinical practice.
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Affiliation(s)
- Francesca Bonello
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Lorenzo Cani
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Mattia D'Agostino
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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