The clinical significance of CD49e and CD56 for multiple myeloma in the novel agents era
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ORIGINAL PAPER
The clinical significance of CD49e and CD56 for multiple myeloma in the novel agents era Miyuki Okura1 · Naoko Ida1 · Takahiro Yamauchi1 Received: 27 May 2020 / Accepted: 26 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Multiple myeloma (MM) is a hematological malignancy characterized by the proliferation of abnormal plasma cells in bone marrow. Flow cytometry distinguishes between normal and abnormal plasma cells by evaluating cluster of differentiation (CD) 56 and CD19 expression patterns. Moreover, immunophenotyping of mature plasma cell 1 (MPC-1) and very late antigen-5 (CD49e) identifies the maturity of MM as mature (MPC-1+, CD49e+), intermediate (MPC-1+, CD49e–), or immature (MPC-1–, CD49e–). We retrospectively examined the effects of surface marker expression and maturity subtype on overall survival (OS) and time to next treatment (TNT) among 55 patients (25 males, 30 females) with symptomatic MM. All patients were treated with regimens containing bortezomib (BOR) (n = 39) or lenalidomide (LEN) (n = 16) as the initial treatment. Median age at diagnosis was 72 years (range: 36–88). The lack of CD56, an aberrant marker, was associated with significantly worse prognosis compared with C D56+ MM (median OS: 24 vs. 60 months, respectively; p = 0.0050). + In CD49e MM, defined as mature type, no significant difference was seen in TNT of the initial treatment, regardless of whether it was a BOR-based regimen or LEN + dexamethasone (Ld) therapy. On the other hand, in CD49e– MM, defined as immature/intermediate type, TNT of Ld therapy was significantly longer than that of BOR-based regimens (median TNT: undefined vs. 12 months, respectively; p = 0.0043). These results suggest that Ld therapy is more effective than BOR-based therapy for CD49e– MM and thus may aid regimen-related decisions in the novel agents era. Keywords Multiple myeloma · Surface marker · CD49e · Lenalidomide
Introduction Multiple myeloma (MM) is a hematological malignancy characterized by the proliferation of abnormal plasma cells in bone marrow. Flow cytometry (FCM) is a fundamental tool for distinguishing between normal and abnormal plasma cells. The expression pattern of cluster of differentiation (CD) 56 and CD19 generally identifies MM cells [1]. Normal plasma cells show CD19+ and CD56– patterns. On the other hand, CD19 is negative in almost all MM, and CD56 is characteristically expressed in 70–80% of MM, but not Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12032-020-01423-4) contains supplementary material, which is available to authorized users. * Miyuki Okura ookura@u‑fukui.ac.jp 1
Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23‑3 Shimoaizuki, Matsuoka, Eiheiji‑cho, Yoshida‑gun, Fukui 910‑1193, Japan
on the surface of normal plasma cells [2–4]. It has been D56+ reported that 65% of MM cells show CD19– and C patterns, 30% show double-negative, and 5% show double
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