Prognostic significance of immunoparesis in newly diagnosed multiple myeloma patients who achieved deep response
10.3760/cma.j.cn112138-20211108-00783
- VernacularTitle:免疫麻痹对达深度缓解新诊断多发性骨髓瘤患者预后的意义
- Author:
Jiahui YIN
1
;
Tingting XU
;
Ying WANG
;
Wenming CHEN
;
Aijun LIU
Author Information
1. 首都医科大学附属北京朝阳医院血液科，北京 100020
- Keywords:
Multiple myeloma;
Disease-free survival;
Prognosis;
Immunoparalysis
- From:
Chinese Journal of Internal Medicine
2022;61(10):1152-1157
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of immune status on disease progression in patients with newly diagnosed multiple myeloma (NDMM) achieving deep response.Methods:Clinical data of 125 NDMM patients at Beijing Chaoyang Hospital from August 2015 to February 2020 were retrospectively analyzed who achieved very good partial response (VGPR) or better after front-line treatment. The immune status and its influence on progression-free survival (PFS) were analyzed.Results:(1) All patients received novel drug regimens, and 50.4% (63/125) patients followed by autologous stem cell transplantation (ASCT). The rate of complete response (CR) as best efficacy was 89.6%, in which 66.4% achieved CR and MRD negativity tested by second generation flow cytometry. (2) Cox multivariate analysis suggested that persistent severe immunoparesis 3 months and 6 months since the best response was an independent poor prognostic factor for PFS. (3) The 3-year PFS rate in the severe immunoparesis group was significantly lower than that in the control group (41.3% vs. 64.4%, P=0.021). (4) The 3-year PFS rates in patients with persistent severe immunoparesis at 3 months or 6 months were significantly lower (30.0% vs. 63.5%, P<0.001; 16.4% vs. 63.8%, P<0.001 respectively). (5) Even in those achieving CR and negative MRD, the 3-year PFS rate when severe immunoparesis lasted 6 months was significantly lower (22.2% vs. 83.2%, P=0.005). Conclusion:The immune status in NDMM patients achieving deep response is closely related to survival. Persistent severe immunoparesis indicates early progression of the disease.
