Objective: To explore the characteristics of the immunophenotypic expression of bone marrow monocytes (M) and its clinical significance in patients with multiple myeloma (MM).
Methods: The monocyte immunophenotypes expression of 67 MM and 30 anemic patients (control group) were detected by flow cytometry. The immunophenotypes that exhibited statistical differences from the control group were screened out. Further univariate and multivariate regression was used analyze the risk factors affecting the prognosis. The effect of monocyte immunophenotype on the prognosis of MM was analyzed. The correlation of CD38+ monocytes with clinical features was explored.
Results: The percentages of CD138+ monocytes (CD138+ M%), CD27+ monocytes (CD27+M%), and CD56+ monocytes (CD56+M%) in the MM group were significantly higher than that in the control group(P <0.05), but the percentages of CD38+ monocytes (CD38+ M%) and HLA-DR+ monocytes (HLA-DR+M%) were significantly lower than that in the control group (P < 0.01). The median progression-free survival (PFS) was shorter in the low CD38+ monocyte proportion (LCD38+ M%) group compared to the high CD38+ monocyte proportion (HCD38+M%) group. Additionally, the median overall survival (OS) was significantly shorter in the low CD138+ monocyte proportion (LCD138+M%), low CD27+ monocyte proportion (LCD27+M%), low CD38+ monocyte proportion (LCD38+M%), and low HLA-DR+ monocyte proportion (LHLA-DR+M%) groups. Cox regression analysis showed that the low CD38+M% was an independent risk factor for OS. The LCD38+M% group had significantly higher proportions of involved/uninvolved free light chain ratios ≥100 and 1q21+ compared to the HCD38+M% group (P < 0.05). Moreover, the proportion of CD38- myeloma cells was significantly higher in the LCD38+M% group than that in the HCD38+M% group (P < 0.05).
Conclusion: The expression of CD38+ monocytes in bone marrow of MM patients is closely related to the prognosis and clinical characteristics. CD38+ monocytes maybe used to predict prognosis and guide treatment decisions.
题目: 多发性骨髓瘤患者骨髓单核细胞免疫表型特点及其临床意义.
目的: 探讨多发性骨髓瘤（MM）患者骨髓单核细胞免疫表型表达的特点及其临床意义。.
方法: 采用流式细胞术检测67例MM患者和30例贫血患者（对照组）骨髓单核细胞免疫表型表达，筛选出与对照组有统计学差异的免疫表型。进一步采用单因素及多因素回归分析影响预后的危险因素，分析单核细胞免疫表型对MM预后的影响，进一步分析CD38+单核细胞与临床特点的相关性。.
结果: MM组中CD138+单核细胞比例（CD138+ M%）、CD27+单核细胞比例（CD27+ M%）、CD56+单核细胞比例（CD56+M%）显著高于对照组(P < 0.05)；而CD38+单核细胞比例（CD38+M%）、HLA-DR+单核细胞比例（HLA-DR+M%）显著低于对照组(P < 0.01)。低CD38+M%组中位PFS低于高CD38+M%组；低CD138+M%、低CD27+M%、低CD38+M%、低HLA-DR+M%组中位OS显著缩短。Cox回归分析结果显示，低CD38+M%是预后的独立危险因素。低CD38+M%组受累/非受累游离轻链比值≥100比例及1q21+比例较高CD38+M%组明显升高(P < 0.05)；低CD38+M%组骨髓瘤细胞CD38-所占比例显著高于高CD38+M%组（P < 0.05）。.
结论: MM患者骨髓CD38+单核细胞的表达与患者预后及临床特点密切相关，或可用来评估预后，指导治疗。.
Keywords: multiple myeloma; monocyte immunophenotype; flow cytometry; prognosis.