A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma
Abstract Objective Despite the availability of new agents, elderly patients with multiple myeloma (MM) usually present with poor outcomes due to the heterogeneity of disease conditions, especially immune deficiency. Regulatory B cells (Bregs) can be involved in immune defects by exerting immune regu...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5228 |
| _version_ | 1797903118225113088 |
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| author | Wenjiao Tang Yan Li Zhongqing Zou Jian Cui Fangfang Wang Yuhuan Zheng Li Hou Ling Pan Bing Xiang Hong Chang Li Zhang Ting Niu |
| author_facet | Wenjiao Tang Yan Li Zhongqing Zou Jian Cui Fangfang Wang Yuhuan Zheng Li Hou Ling Pan Bing Xiang Hong Chang Li Zhang Ting Niu |
| author_sort | Wenjiao Tang |
| collection | DOAJ |
| description | Abstract Objective Despite the availability of new agents, elderly patients with multiple myeloma (MM) usually present with poor outcomes due to the heterogeneity of disease conditions, especially immune deficiency. Regulatory B cells (Bregs) can be involved in immune defects by exerting immune regulatory functions in MM. In order to provide more evidence‐based practice for the elderly MM, the study established and assessed a stratified therapeutic model with studies on Bregs for Chinese Elderly Multiple Myeloma in 2021 (CEMM2021). Methods In this open‐label, non‐interventional, prospective study in the real world, 159 newly diagnosed MM (NDMM) patients over 65 years old were sequentially recruited and bone marrow aspirates prior to treatment were obtained to detect the ratios of Bregs by flow cytometry. Results Based on the CEMM2021 model, 147 patients had received at least one cycle of induction therapy, including bortezomib/dexamethasone (Bd) (n = 80), lenalidomide/dexamethasone (Rd) (n = 27), Bd with a third agent X (Bd + X) (n = 27), and other regimens (n = 13). The proportions of patients achieving very good partial response or better were comparable among Bd, Bd + X, and Rd groups (41.9% vs. 54.5% vs. 44.0%, p = 0.472). Besides, the progression‐free survival (PFS) and overall survival (OS) were not significantly different among Rd, Bd, and Bd + X groups. Multivariable analysis showed that induction efficacy less than partial response (PR) were poor prognostic factors for PFS, while Revised‐International Staging System (R‐ISS) III and efficacy less than PR were poor prognostic factors for OS. This study also found that the ratios of bone marrow Bregs <10% (p = 0.036) and SUVmax of PET‐CT scan >4.2 (p = 0.000) were closely correlated with OS in the elderly MM. Conclusions For the elderly NDMM, the CEMM2021 algorithm in our center might provide a valuable reference for the guidance of therapeutic strategies, with the combination of Bregs resulting in an effective and clinically meaningful prediction in contemporary treatment. |
| first_indexed | 2024-04-10T09:27:55Z |
| format | Article |
| id | doaj.art-a85ffc7b55bf40abbf8bd2d914940772 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T09:27:55Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj.art-a85ffc7b55bf40abbf8bd2d9149407722023-02-19T18:54:07ZengWileyCancer Medicine2045-76342023-02-011233054306710.1002/cam4.5228A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myelomaWenjiao Tang0Yan Li1Zhongqing Zou2Jian Cui3Fangfang Wang4Yuhuan Zheng5Li Hou6Ling Pan7Bing Xiang8Hong Chang9Li Zhang10Ting Niu11Department of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaDepartment of Hematology Institute of Hematology, West China Hospital, Sichuan University Chengdu Sichuan ChinaAbstract Objective Despite the availability of new agents, elderly patients with multiple myeloma (MM) usually present with poor outcomes due to the heterogeneity of disease conditions, especially immune deficiency. Regulatory B cells (Bregs) can be involved in immune defects by exerting immune regulatory functions in MM. In order to provide more evidence‐based practice for the elderly MM, the study established and assessed a stratified therapeutic model with studies on Bregs for Chinese Elderly Multiple Myeloma in 2021 (CEMM2021). Methods In this open‐label, non‐interventional, prospective study in the real world, 159 newly diagnosed MM (NDMM) patients over 65 years old were sequentially recruited and bone marrow aspirates prior to treatment were obtained to detect the ratios of Bregs by flow cytometry. Results Based on the CEMM2021 model, 147 patients had received at least one cycle of induction therapy, including bortezomib/dexamethasone (Bd) (n = 80), lenalidomide/dexamethasone (Rd) (n = 27), Bd with a third agent X (Bd + X) (n = 27), and other regimens (n = 13). The proportions of patients achieving very good partial response or better were comparable among Bd, Bd + X, and Rd groups (41.9% vs. 54.5% vs. 44.0%, p = 0.472). Besides, the progression‐free survival (PFS) and overall survival (OS) were not significantly different among Rd, Bd, and Bd + X groups. Multivariable analysis showed that induction efficacy less than partial response (PR) were poor prognostic factors for PFS, while Revised‐International Staging System (R‐ISS) III and efficacy less than PR were poor prognostic factors for OS. This study also found that the ratios of bone marrow Bregs <10% (p = 0.036) and SUVmax of PET‐CT scan >4.2 (p = 0.000) were closely correlated with OS in the elderly MM. Conclusions For the elderly NDMM, the CEMM2021 algorithm in our center might provide a valuable reference for the guidance of therapeutic strategies, with the combination of Bregs resulting in an effective and clinically meaningful prediction in contemporary treatment.https://doi.org/10.1002/cam4.5228elderlymultiple myelomaregulatory B cellstratificationsurvival |
| spellingShingle | Wenjiao Tang Yan Li Zhongqing Zou Jian Cui Fangfang Wang Yuhuan Zheng Li Hou Ling Pan Bing Xiang Hong Chang Li Zhang Ting Niu A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma Cancer Medicine elderly multiple myeloma regulatory B cell stratification survival |
| title | A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma |
| title_full | A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma |
| title_fullStr | A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma |
| title_full_unstemmed | A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma |
| title_short | A stratified therapeutic model incorporated with studies on regulatory B cells for elderly patients with newly diagnosed multiple myeloma |
| title_sort | stratified therapeutic model incorporated with studies on regulatory b cells for elderly patients with newly diagnosed multiple myeloma |
| topic | elderly multiple myeloma regulatory B cell stratification survival |
| url | https://doi.org/10.1002/cam4.5228 |
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