Minimal residual disease status improved the response evaluation in patients with Waldenström’s macroglobulinemia

Frontiers in Immunology

Immunology

Guifang Ouyang¹  Zanzan Wang¹  Tingyu Wang²  Jiawen Chen²  Wenyang Huang²  Qi Wang²  Wenjie Xiong²  Hao Sun²  Rui Lyu²  Huijun Wang²  Jianxiang Wang²  Zhijian Xiao²  Shuhua Yi²  Wei Liu²  Ying Yu²  Lugui Qiu²  Weiwei Sui²  Gang An²  Yuting Yan²  Dehui Zou²  Yanshan Huang² 

[1] Department of Hematology, Ningbo First Hospital, Ningbo, China;State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China;Department of Lymphma & Myeloma, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China;Tianjin Institutes of Health Science, Tianjin, China;

关键词: Waldenström’s macroglobulinemia;    minimal residual disease;    multiparameter flow cytometry;    prognosis;    remission;   

DOI  :  10.3389/fimmu.2023.1171539

 received in 2023-02-22, accepted in 2023-04-25,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionMinimal residual disease (MRD) has been recognized as an important prognostic factor of survival in patients with hematological malignancies. However, the prognostic value of MRD in Waldenström macroglobulinemia (WM) remains unexplored.MethodsWe analyzed 108 newly diagnosed WM patients receiving systematic therapy and assessed for MRD by multiparameter flow cytometry (MFC) using bone marrow samples.ResultsOf the total patients, 34 (31.5%) achieved undetectable MRD (uMRD). A hemoglobin level of >115 g/L (P=0.03), a serum albumin level of >35 g/L (P=0.01), a β2-MG level of ≤3 mg/L (P=0.03), and a low-risk International Prognostic Scoring System for WM (IPSSWM) stage (P<0.01) were associated with a higher rate of uMRD. Improvements in monoclonal immunoglobulin (P<0.01) and hemoglobin (P=0.03) levels were more evident in uMRD patients compared with that in MRD-positive patients. The 3-year progression-free survival (PFS) was better in uMRD patients compared with that in MRD-positive patients (96.2% vs. 52.8%; P=0.0012). Landmark analysis also showed that uMRD patients had better PFS compared with MRD-positive patients after 6 and 12 months. Patients who achieved partial response (PR) and uMRD had a 3-year PFS of 100%, which was significantly higher than that of patients with MRD-positive PR (62.6%, P=0.029). Multivariate analysis showed that MRD positivity was an independent factor of PFS (HR: 2.55, P=0.03). Moreover, the combination of the 6th International Workshop on WM assessment (IWWM-6 Criteria) and MRD assessment had a higher 3-year AUC compared with the IWWM-6 criteria alone (0.71 vs. 0.67).DiscussionMRD status assessed by MFC is an independent prognostic factor for PFS in patients with WM, and its determination could improve the precision of response evaluation, especially in patients who achieved PR.

【 授权许可】

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Copyright © 2023 Xiong, Wang, Wang, Yu, Huang, Sun, Chen, Lyu, Wang, Yan, Wang, Liu, An, Sui, Huang, Zou, Xiao, Wang, Ouyang, Qiu and Yi