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Tian MR, Yang PY, Yue TT, Li MY, Zhang YJ, Zhang MX, Zhang LM, Yan YR, Hu ZL, Du YZ, Li YY, Jin FY. [A predictive model based on risk factors for early mortality in patients with newly diagnosed multiple myeloma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:666-672. [PMID: 34547873 PMCID: PMC8501273 DOI: 10.3760/cma.j.issn.0253-2727.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Indexed: 11/09/2022]
Abstract
Objective: To investigate risk factors for early mortality (EM) in patients with newly diagnosed multiple myeloma (NDMM) and to build an EM-predictive model. Methods: In a cohort of 275 patients with NDMM, risk factors for EM at 6, 12, and 24 months after diagnosis (EM6, EM12, and EM24, respectively) were determined to establish a model to predict EM. Results: The rates of EM6, EM12, and EM24 were 5.5% , 12.7% , and 30.2% , respectively. The most common cause for EM was disease progression/relapse, accounting for 60.0% , 77.1% , and 84.3% of EM6, EM12, and EM24, respectively. EM6 was associated with corrected serum calcium >2.75 mmol/L and platelet count <100×10(9)/L, whereas risk factors for EM12 included age >75 years, ISS Ⅲ, R-ISS Ⅲ, corrected serum calcium >2.75 mmol/L, serum creatinine >177 µmol/L, platelet count <100×10(9)/L, and bone marrow plasma cell ratio ≥ 60% . In addition to the risk factors for EM12, EM24 was also associated with male sex and 1q21 gain. By multivariate analysis, age >75 years, platelet count <100×10(9)/L, and 1q21 gain were independent risk factors for EM24 but there were no independent risk factors significantly associated with EM6 and EM12. Using a scoring system including these three risk factors, a Cox model for EM24 was generated to distinguish patients with low (score<3) and high (score ≥ 3) risk. The sensitivity and specificity of the model were 20.7% and 99.2% , respectively. Further, an internal validation performed in a cohort of 183 patients with NDMM revealed that the probability of EM24 in high-risk patients was 26 times higher than that in low-risk patients. Moreover, this model was also able to predict overall survival. The median overall survival of patients with scores of 0, 1, 2, 3, 4, and 5 were 59, 41, 22, 17.5, and 16 months, respectively. Conclusion: In the study cohort, the EM6, EM12, and EM24 rates were 5.5% , 12.7% , and 30.2% , respectively, and disease progression or relapse were main causes of EM. An EM24-predictive model built on three independent risk factors for EM24 (age>75 years, platelet count<100×10(9)/L, and 1q21 gain) might predict EM risk and overall survival.
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Affiliation(s)
- M R Tian
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - P Y Yang
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - T T Yue
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - M Y Li
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - Y J Zhang
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - M X Zhang
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - L M Zhang
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - Y R Yan
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - Z L Hu
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - Y Z Du
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - Y Y Li
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
| | - F Y Jin
- Department of Hematology, the First Hospital of Jilin University, Changchun 130021, China
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Xu J, Sun Y, Jiang J, Xu Z, Li J, Xu T, Liu P. Globular C1q Receptor (gC1qR/p32/HABP1) Suppresses the Tumor-Inhibiting Role of C1q and Promotes Tumor Proliferation in 1q21-Amplified Multiple Myeloma. Front Immunol 2020; 11:1292. [PMID: 32760394 PMCID: PMC7372013 DOI: 10.3389/fimmu.2020.01292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/21/2020] [Indexed: 12/24/2022] Open
Abstract
Immunodeficiencies are widely becoming known as important features of multiple myeloma (MM) and may promote the proliferation of malignant cells as well as confer resistance to therapy. Few studies focus on the immunomodulatory effects of the complement system on MM. This study aims to explore the role of C1q in MM patients. Plasma C1q was found to be significantly reduced in MM patients, and the amount of C1q deposited around the CD138+ cells in bone marrow (BM) biopsy sections was observed to be much higher, especially in the subgroup with 1q21 amplification (Amp1q21). CD138+ cells expressed higher levels of C1q receptors (C1qRs) than CD138− cells. Patients with Amp1q21 expressed higher levels of globular C1qR (gC1qR), whereas patients without Amp21 expressed higher levels of collagen tail C1qR (cC1qR). Additionally, gC1qR was noted to suppress the MM-inhibiting role of C1q in H929, U266, and MM1S. gC1qR interacts with insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3), which also suppressed the function of C1q and regulated CDC28 protein kinase regulatory subunit 1B (CKS1B) mRNA. In summary, gC1qR suppressed the MM-inhibiting role of C1q and regulated CKS1B mRNA in promoting tumor proliferation via IGF2BP3 in 1q21-amplified MM. Our findings provide novel evidence on how MM cells evade the immune system and promote survival as well as suggest possible novel targets for future therapies of MM.
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Affiliation(s)
- Jiadai Xu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yifeng Sun
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jifeng Jiang
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhao Xu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Li
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tianhong Xu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Peng Liu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
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Hu JJ, Nie SM, Gao Y, Yan XS, Huang JX, Li TL, Liu SS, Mao CX, Zhou JJ, Xu YJ, Wang W, Meng FJ, Feng XQ. [The correlations and prognostic value of neutrophil to lymphocyte ratio, immunophenotype and cytogenetic abnormalities in patients with newly diagnosed multiple myeloma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:1044-1046. [PMID: 32023739 PMCID: PMC7342691 DOI: 10.3760/cma.j.issn.0253-2727.2019.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Indexed: 11/17/2022]
Affiliation(s)
- J J Hu
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - S M Nie
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y Gao
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - X S Yan
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J X Huang
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - T L Li
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - S S Liu
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - C X Mao
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - J J Zhou
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y J Xu
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - W Wang
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - F J Meng
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - X Q Feng
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
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