Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients

Oren Pasvolsky; Denái R. Milton; Mikael Rauf; Sassine Ghanem; Adeel Masood; Ali H. Mohamedi; Mark R. Tanner; Qaiser Bashir; Samer Srour; Neeraj Saini; Paul Lin; Jeremy Ramdial; Yago Nieto; Guilin Tang; Hans C. Lee; Krina K. Patel; Partow Kebriaei; Sheeba K. Thomas; Donna M. Weber; Robert Z. Orlowski; Katy Rezvani; Richard Champlin; Elizabeth J. Shpall; Pei Lin; Muzaffar H. Qazilbash

doi:10.1038/s41408-023-00842-6

Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients

Oren Pasvolsky, Denái R. Milton, Mikael Rauf, Sassine Ghanem, Adeel Masood, Ali H. Mohamedi, Mark R. Tanner, Qaiser Bashir, Samer Srour, Neeraj Saini, Paul Lin, Jeremy Ramdial, Yago Nieto, Guilin Tang, Hans C. Lee, Krina K. Patel, Partow Kebriaei, Sheeba K. Thomas, Donna M. Weber, Robert Z. OrlowskiKaty Rezvani, Richard Champlin, Elizabeth J. Shpall, Pei Lin, Muzaffar H. Qazilbash

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3 Scopus citations

Abstract

Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS.

Original language	English (US)
Article number	68
Journal	Blood cancer journal
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41408-023-00842-6
State	Published - Dec 2023

ASJC Scopus subject areas

Hematology
Oncology

MD Anderson CCSG core facilities

Biostatistics Resource Group

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10.1038/s41408-023-00842-6

Cite this

Pasvolsky, O., Milton, D. R., Rauf, M., Ghanem, S., Masood, A., Mohamedi, A. H., Tanner, M. R., Bashir, Q., Srour, S., Saini, N., Lin, P., Ramdial, J., Nieto, Y., Tang, G., Lee, H. C., Patel, K. K., Kebriaei, P., Thomas, S. K., Weber, D. M., ... Qazilbash, M. H. (2023). Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients. Blood cancer journal, 13(1), Article 68. https://doi.org/10.1038/s41408-023-00842-6

Pasvolsky, O , Milton, DR, Rauf, M, Ghanem, S, Masood, A, Mohamedi, AH, Tanner, MR, Bashir, Q , Srour, S , Saini, N , Lin, P , Ramdial, J , Nieto, Y , Tang, G , Lee, HC , Patel, KK , Kebriaei, P , Thomas, SK , Weber, DM , Orlowski, RZ , Rezvani, K , Champlin, R , Shpall, EJ , Lin, P & Qazilbash, MH 2023, 'Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients', Blood cancer journal, vol. 13, no. 1, 68. https://doi.org/10.1038/s41408-023-00842-6

@article{f03648033e0d4d4c96ae413bce845104,

title = "Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients",

abstract = "Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS.",

author = "Oren Pasvolsky and Milton, {Den{\'a}i R.} and Mikael Rauf and Sassine Ghanem and Adeel Masood and Mohamedi, {Ali H.} and Tanner, {Mark R.} and Qaiser Bashir and Samer Srour and Neeraj Saini and Paul Lin and Jeremy Ramdial and Yago Nieto and Guilin Tang and Lee, {Hans C.} and Patel, {Krina K.} and Partow Kebriaei and Thomas, {Sheeba K.} and Weber, {Donna M.} and Orlowski, {Robert Z.} and Katy Rezvani and Richard Champlin and Shpall, {Elizabeth J.} and Pei Lin and Qazilbash, {Muzaffar H.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1038/s41408-023-00842-6",

language = "English (US)",

volume = "13",

journal = "Blood cancer journal",

issn = "2044-5385",

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TY - JOUR

T1 - Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients

AU - Pasvolsky, Oren

AU - Milton, Denái R.

AU - Rauf, Mikael

AU - Ghanem, Sassine

AU - Masood, Adeel

AU - Mohamedi, Ali H.

AU - Tanner, Mark R.

AU - Bashir, Qaiser

AU - Srour, Samer

AU - Saini, Neeraj

AU - Lin, Paul

AU - Ramdial, Jeremy

AU - Nieto, Yago

AU - Tang, Guilin

AU - Lee, Hans C.

AU - Patel, Krina K.

AU - Kebriaei, Partow

AU - Thomas, Sheeba K.

AU - Weber, Donna M.

AU - Orlowski, Robert Z.

AU - Rezvani, Katy

AU - Champlin, Richard

AU - Shpall, Elizabeth J.

AU - Lin, Pei

AU - Qazilbash, Muzaffar H.

PY - 2023/12

Y1 - 2023/12

N2 - Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS.

AB - Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC− in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC− (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC− groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS.

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DO - 10.1038/s41408-023-00842-6

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AN - SCOPUS:85159545800

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JO - Blood cancer journal

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Impact of clonal plasma cells in autografts on outcomes in high-risk multiple myeloma patients

Abstract

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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