https://orcid.org/0000-0002-2815-4568
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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.
KEY MESSAGES
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.
Author contributions
CS, QL and AL conceived and designed the study; QL and AL conducted the literature search, data extraction and analysis; LZ, JL prepared figures and tables; FZ, and AX advised on data collection and methodology; QL and AL wrote the manuscript; BZ and LC performed the language editing; YH and CS reviewed the manuscript and revised it. All authors read and approved the final manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.