Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis

Objectives Multiple myeloma (MM) is a malignant plasma cell disorder. The most widely accepted staging system for MM is the revised International Staging System based on cytogenetic and clinical biomarkers. The circulating clonal plasma cells (CPCs) were reported to have potential prognostic impact...

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Main Authors: Jie Ma, Mengmeng Zhang, Xiaoyan Liu, Wu Ye, Jili Deng, Feifei Wu, Congli Zhang, Qingfeng Yu, Li Cao, Silin Gan
Format: Article
Language:English
Published: BMJ Publishing Group 2024-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/1/e071548.full
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author Jie Ma
Mengmeng Zhang
Xiaoyan Liu
Wu Ye
Jili Deng
Feifei Wu
Congli Zhang
Qingfeng Yu
Li Cao
Silin Gan
author_facet Jie Ma
Mengmeng Zhang
Xiaoyan Liu
Wu Ye
Jili Deng
Feifei Wu
Congli Zhang
Qingfeng Yu
Li Cao
Silin Gan
author_sort Jie Ma
collection DOAJ
description Objectives Multiple myeloma (MM) is a malignant plasma cell disorder. The most widely accepted staging system for MM is the revised International Staging System based on cytogenetic and clinical biomarkers. The circulating clonal plasma cells (CPCs) were reported to have potential prognostic impact on MM. Among various diagnostic approaches, multiparametric flow cytometry (FCM) offers heightened sensitivity, minimal invasiveness and reproducibility. We conducted a meta-analysis to evaluate the prognostic value of quantifying CPCs via FCM in newly diagnosed symptomatic MM (NDMM) patients.Design Systematic review and meta-analysis.Data source PubMed, Web of Science, Embase and references of included studies.Eligibility criteria for selecting studies We included observational studies that evaluated the prognostic value of CPCs detected by FCM in NDMM.Data extraction and synthesis Data were screened and extracted independently by two investigators. The pooled results originated from random effects models. The primary endpoint was overall survival (OS). The secondary endpoint was progression-free survival (PFS). To evaluate the prognostic value of CPCs in NDMM, HRs and their 95% CI for both OS and PFS were derived using COX multivariable models. These values were then used to compute the pooled estimated effect.Results Our meta-analysis encompassed a total of 2704 NDMM patients from 11 studies up to 27 August 2022. The pooled HR for OS and PFS in CPC-positive (CPCs+) group and CPC-negative group were 1.95 (95% CI 1.24 to 3.07) and 2.07 (95% CI 1.79 to 2.39), respectively. The autologous stem cell transplantation (ASCT) failed to eliminate the adverse impact on OS and PFS. The heterogeneity may stem from the use of novel agents or traditional chemotherapy as initial treatment.Conclusion This meta-analysis indicates CPCs+ had an adverse impact on the prognosis of NDMM patients in the total population, and the adverse impact could not be eliminated by ASCT.PROSPERO registration number CRD42021272381.
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spelling doaj-art-4d36ae80d4154bbdbb448c74bf17934b2025-08-20T02:13:28ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2022-071548Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysisJie Ma0Mengmeng Zhang1Xiaoyan Liu2Wu Ye3Jili Deng4Feifei Wu5Congli Zhang6Qingfeng Yu7Li Cao8Silin Gan9Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaPeking University People’s Hospital, Beijing, China2Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Hematology, West China Hospital of Sichuan University, Chengdu, Sichuan, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, ChinaDepartment of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaDepartment of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaObjectives Multiple myeloma (MM) is a malignant plasma cell disorder. The most widely accepted staging system for MM is the revised International Staging System based on cytogenetic and clinical biomarkers. The circulating clonal plasma cells (CPCs) were reported to have potential prognostic impact on MM. Among various diagnostic approaches, multiparametric flow cytometry (FCM) offers heightened sensitivity, minimal invasiveness and reproducibility. We conducted a meta-analysis to evaluate the prognostic value of quantifying CPCs via FCM in newly diagnosed symptomatic MM (NDMM) patients.Design Systematic review and meta-analysis.Data source PubMed, Web of Science, Embase and references of included studies.Eligibility criteria for selecting studies We included observational studies that evaluated the prognostic value of CPCs detected by FCM in NDMM.Data extraction and synthesis Data were screened and extracted independently by two investigators. The pooled results originated from random effects models. The primary endpoint was overall survival (OS). The secondary endpoint was progression-free survival (PFS). To evaluate the prognostic value of CPCs in NDMM, HRs and their 95% CI for both OS and PFS were derived using COX multivariable models. These values were then used to compute the pooled estimated effect.Results Our meta-analysis encompassed a total of 2704 NDMM patients from 11 studies up to 27 August 2022. The pooled HR for OS and PFS in CPC-positive (CPCs+) group and CPC-negative group were 1.95 (95% CI 1.24 to 3.07) and 2.07 (95% CI 1.79 to 2.39), respectively. The autologous stem cell transplantation (ASCT) failed to eliminate the adverse impact on OS and PFS. The heterogeneity may stem from the use of novel agents or traditional chemotherapy as initial treatment.Conclusion This meta-analysis indicates CPCs+ had an adverse impact on the prognosis of NDMM patients in the total population, and the adverse impact could not be eliminated by ASCT.PROSPERO registration number CRD42021272381.https://bmjopen.bmj.com/content/14/1/e071548.full
spellingShingle Jie Ma
Mengmeng Zhang
Xiaoyan Liu
Wu Ye
Jili Deng
Feifei Wu
Congli Zhang
Qingfeng Yu
Li Cao
Silin Gan
Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
BMJ Open
title Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
title_full Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
title_fullStr Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
title_full_unstemmed Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
title_short Prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
title_sort prognostic value of circulating plasma cells detected by flow cytometry in newly diagnosed multiple myeloma patients a systematic review and meta analysis
url https://bmjopen.bmj.com/content/14/1/e071548.full
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