Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study
Purpose Previous studies have shown that ≥2% circulating tumor cells (CTCs) in multiple myeloma are associated with a prognosis similar to primary plasma cell leukemia. This study aims to examine this ultra-high-risk patient subset and evaluate their clinical outcomes in a real-world clinical settin...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2496796 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850173922113224704 |
|---|---|
| author | Dong Liang Yurong Yan Shenrui Bai Weiling Xu Qiaoli Wang Demei Feng Yuying Bu Min Zeng Xiaomiao Nie Yuan Feng Xiaoqin Chen Zhongjun Xia Yang Liang Fengyan Jin Hua Wang |
| author_facet | Dong Liang Yurong Yan Shenrui Bai Weiling Xu Qiaoli Wang Demei Feng Yuying Bu Min Zeng Xiaomiao Nie Yuan Feng Xiaoqin Chen Zhongjun Xia Yang Liang Fengyan Jin Hua Wang |
| author_sort | Dong Liang |
| collection | DOAJ |
| description | Purpose Previous studies have shown that ≥2% circulating tumor cells (CTCs) in multiple myeloma are associated with a prognosis similar to primary plasma cell leukemia. This study aims to examine this ultra-high-risk patient subset and evaluate their clinical outcomes in a real-world clinical setting.Methods We included 1,056 newly diagnosed multiple myeloma patients treated with novel agents. CTCs levels were determined via morphological assessment on peripheral blood smears, using a 2% cutoff to stratify patients into <2% and ≥2% CTCs groups. We then evaluated clinical outcomes across these groups.Results Patients with ≥2% CTCs constitute an ultra-high-risk subgroup, with outcomes resembling those of primary plasma cell leukemia. Survival outcomes improved for patients receiving daratumumab-based quadruplet therapy. Single autologous stem cell transplantation (ASCT) partially improved outcomes for patients with ≥2% CTCs. Achieving complete remission (CR) after induction treatment did not confer a better prognosis for this population. Furthermore, one high-risk cytogenetic abnormality (HRA) worsened outcomes in the <2% CTC group, while ≥2 HRA were associated with poorer outcomes in the ≥2% CTC group. Concurrent 1q21+ and other HRA further conferred a worse prognosis. In de novo extramedullary extraosseous (EME) multiple myeloma, defined as patients presenting with soft tissue or visceral plasmacytomas not connected to bone at initial diagnosis, ≥2% CTCs remained a strong predictor of poor prognosis.Conclusion Our study suggests that patients with ≥2% CTCs represent a distinct ultra-high-risk subgroup in multiple myeloma and warrant separate consideration. VRD, IRD, DVRD, and DRD were reliable choices as frontline therapies for patients with <2% CTCs. Daratumumab-based quadruplet therapy may be a promising option for patients with ≥2% CTCs. Further research should continue to explore this specific aspect in greater depth. |
| format | Article |
| id | doaj-art-9cb641a1d34547bf982c9fa1ec658ac5 |
| institution | OA Journals |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-9cb641a1d34547bf982c9fa1ec658ac52025-08-20T02:19:45ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2496796Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter studyDong Liang0Yurong Yan1Shenrui Bai2Weiling Xu3Qiaoli Wang4Demei Feng5Yuying Bu6Min Zeng7Xiaomiao Nie8Yuan Feng9Xiaoqin Chen10Zhongjun Xia11Yang Liang12Fengyan Jin13Hua Wang14State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaHematology Department, First Hospital of Jilin University, Changchun, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaRadiology Department, First Hospital of Jilin University, Changchun, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaHematology Department, First Hospital of Jilin University, Changchun, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, ChinaPurpose Previous studies have shown that ≥2% circulating tumor cells (CTCs) in multiple myeloma are associated with a prognosis similar to primary plasma cell leukemia. This study aims to examine this ultra-high-risk patient subset and evaluate their clinical outcomes in a real-world clinical setting.Methods We included 1,056 newly diagnosed multiple myeloma patients treated with novel agents. CTCs levels were determined via morphological assessment on peripheral blood smears, using a 2% cutoff to stratify patients into <2% and ≥2% CTCs groups. We then evaluated clinical outcomes across these groups.Results Patients with ≥2% CTCs constitute an ultra-high-risk subgroup, with outcomes resembling those of primary plasma cell leukemia. Survival outcomes improved for patients receiving daratumumab-based quadruplet therapy. Single autologous stem cell transplantation (ASCT) partially improved outcomes for patients with ≥2% CTCs. Achieving complete remission (CR) after induction treatment did not confer a better prognosis for this population. Furthermore, one high-risk cytogenetic abnormality (HRA) worsened outcomes in the <2% CTC group, while ≥2 HRA were associated with poorer outcomes in the ≥2% CTC group. Concurrent 1q21+ and other HRA further conferred a worse prognosis. In de novo extramedullary extraosseous (EME) multiple myeloma, defined as patients presenting with soft tissue or visceral plasmacytomas not connected to bone at initial diagnosis, ≥2% CTCs remained a strong predictor of poor prognosis.Conclusion Our study suggests that patients with ≥2% CTCs represent a distinct ultra-high-risk subgroup in multiple myeloma and warrant separate consideration. VRD, IRD, DVRD, and DRD were reliable choices as frontline therapies for patients with <2% CTCs. Daratumumab-based quadruplet therapy may be a promising option for patients with ≥2% CTCs. Further research should continue to explore this specific aspect in greater depth.https://www.tandfonline.com/doi/10.1080/07853890.2025.2496796Circulating tumor cellsclinical outcomemultiple myeloma |
| spellingShingle | Dong Liang Yurong Yan Shenrui Bai Weiling Xu Qiaoli Wang Demei Feng Yuying Bu Min Zeng Xiaomiao Nie Yuan Feng Xiaoqin Chen Zhongjun Xia Yang Liang Fengyan Jin Hua Wang Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study Annals of Medicine Circulating tumor cells clinical outcome multiple myeloma |
| title | Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study |
| title_full | Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study |
| title_fullStr | Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study |
| title_full_unstemmed | Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study |
| title_short | Clinical outcome of ≥2% circulating tumor cells in newly diagnosed multiple myeloma: insights from a multicenter study |
| title_sort | clinical outcome of ≥2 circulating tumor cells in newly diagnosed multiple myeloma insights from a multicenter study |
| topic | Circulating tumor cells clinical outcome multiple myeloma |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2496796 |
| work_keys_str_mv | AT dongliang clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT yurongyan clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT shenruibai clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT weilingxu clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT qiaoliwang clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT demeifeng clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT yuyingbu clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT minzeng clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT xiaomiaonie clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT yuanfeng clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT xiaoqinchen clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT zhongjunxia clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT yangliang clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT fengyanjin clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy AT huawang clinicaloutcomeof2circulatingtumorcellsinnewlydiagnosedmultiplemyelomainsightsfromamulticenterstudy |