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Meta-Analysis
. 2024 Dec;56(1):2338604.
doi: 10.1080/07853890.2024.2338604. Epub 2024 Apr 10.

Circulating plasma cells as a predictive biomarker in Multiple myeloma: an updated systematic review and meta-analysis

Qun Li  1 , Lisha Ai  1 , Liping Zuo  1 , Junying Li  1 , Fei Zhao  1 , Aoshuang Xu  1 , Bo Zhang  1 , Li Cai  1 , Yu Hu  1   2 , Chunyan Sun  1   2
Affiliations
Meta-Analysis

Circulating plasma cells as a predictive biomarker in Multiple myeloma: an updated systematic review and meta-analysis

Qun Li et al. Ann Med. 2024 Dec.

Abstract

Background: Circulating plasma cells (CPCs) are defined by the presence of peripheral blood clonal plasma cells, which would contribute to the progression and dissemination of multiple myeloma (MM). An increasing number of studies have demonstrated the predictive potential of CPCs in the past few years. Therefore, there is a growing need for an updated meta-analysis to identify the specific relationship between CPCs and the prognosis of MM based on the current research status.

Methods: The PubMed, Embase, and Cochrane Library databases were screened to determine eligible studies from inception to November 5, 2023. Publications that reported the prognostic value of CPCs in MM patients were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) and progression-free survival (PFS) were extracted to pool the results. Subgroup analyses were performed based on region, sample size, cut-off value, detection time, initial treatment, and data type. The association between CPCs level and clinicopathological characteristics, including the International Staging System (ISS), Revised-ISS (R-ISS), and cytogenetic abnormalities were also evaluated. Statistical analyses were conducted using STATA 17.0 software.

Results: Twenty-two studies with a total of 5637 myeloma patients were enrolled in the current meta-analysis. The results indicated that myeloma patients with elevated CPCs were expected to have a poor OS (HR = 2.19, 95% CI: 1.81-2.66, p < 0.001) and PFS (HR = 2.45, 95% CI: 1.93-3.12, p < 0.001). Subgroup analyses did not alter the prognostic role of CPCs, regardless of region, sample size, cut-off value, detection time, initial treatment, or data type. Moreover, the increased CPCs were significantly related to advanced tumour stage (ISS III vs. ISS I-II: pooled OR = 2.89, 95% CI: 2.41-3.46, p < 0.001; R-ISS III vs. R-ISS I-II: pooled OR = 3.65, 95% CI: 2.43-5.50, p < 0.001) and high-risk cytogenetics (high-risk vs. standard-risk: OR = 2.22, 95% CI: 1.60-3.08, p < 0.001).

Conclusion: Our meta-analysis confirmed that the increased number of CPCs had a negative impact on the PFS and OS of MM patients. Therefore, CPCs could be a promising prognostic biomarker that helps with risk stratification and disease monitoring.

Keywords: Multiple myeloma; circulating plasma cells; meta-analysis; prognosis; survival.

Plain language summary

There is a growing need for an updated meta-analysis to identify the specific relationship between CPCs and the prognosis of MM based on the current research status.Our meta-analysis revealed that a high CPCs level was significantly associated with worse OS and PFS in MM patients.CPCs could be a promising predictive biomarker that helps with risk stratification and disease monitoring.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Flow diagram of study selection.
Figure 2.
Figure 2.
Meta-analysis of the association between elevated CPCs and OS in MM.
Figure 3.
Figure 3.
Meta-analysis of the association between elevated CPCs and PFS in MM.
Figure 4.
Figure 4.
Sensitivity analysis of the enrolled studies. (A) Sensitivity analysis using the leave-one-out test for OS; (B) Sensitivity analysis using the leave-one-out test for PFS.
Figure 5.
Figure 5.
Publication bias of the studies. (A) Begg’s funnel plot for OS; (B) Begg’s funnel plot for PFS.
See this image and copyright information in PMC

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References

    1. Pulte D, Jansen L, Brenner H.. Changes in long term survival after diagnosis with common hematologic malignancies in the early 21st century. Blood Cancer J. 2020;10(5):56. doi: 10.1038/s41408-020-0323-4. - DOI - PMC - PubMed
    1. Kumar SK, Dispenzieri A, Lacy MQ, et al. . Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014;28(5):1122–1128. doi: 10.1038/leu.2013.313. - DOI - PMC - PubMed
    1. Greipp PR, San Miguel J, Durie BG, et al. . International staging system for multiple myeloma. J Clin Oncol. 2005;23(15):3412–3420. doi: 10.1200/jco.2005.04.242. - DOI - PubMed
    1. Palumbo A, Avet-Loiseau H, Oliva S, et al. . Revised international staging system for multiple myeloma: a report from international myeloma working group. J Clin Oncol. 2015;33(26):2863–2869. doi: 10.1200/jco.2015.61.2267. - DOI - PMC - PubMed
    1. Paiva B, Paino T, Sayagues J-M, et al. . Detailed characterization of multiple myeloma circulating tumor cells shows unique phenotypic, cytogenetic, functional, and circadian distribution profile. Blood. 2013;122(22):3591–3598. doi: 10.1182/blood-2013-06-510453. - DOI - PubMed

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