■循环浆细胞(CPCs)由外周血克隆浆细胞的存在定义,这将有助于多发性骨髓瘤(MM)的进展和传播。在过去的几年中,越来越多的研究证明了CPC的预测潜力。因此,基于目前的研究现状,越来越需要更新的荟萃分析来确定CPCs与MM预后之间的具体关系.
■PubMed,Embase,从开始到2023年11月5日,对Cochrane图书馆数据库进行了筛选,以确定符合条件的研究。包括报道MM患者中CPC预后价值的出版物。提取总生存期(OS)和无进展生存期(PFS)的95%置信区间(CIs)的危险比(HRs),以汇集结果。根据区域进行亚组分析,样本量,截止值,检测时间,初始治疗,和数据类型。CPC水平与临床病理特征之间的关系,包括国际分期系统(ISS),修订-ISS(R-ISS)和细胞遗传学异常也进行了评估。采用STATA17.0软件进行统计分析。
■目前的荟萃分析纳入了22项研究,共5637例骨髓瘤患者。结果表明,患有高CPC的骨髓瘤患者的OS(HR=2.19,95%CI:1.81-2.66,p<0.001)和PFS(HR=2.45,95%CI:1.93-3.12,p<0.001)较差。亚组分析没有改变CPC的预后作用,无论哪个地区,样本量,截止值,检测时间,初始治疗,或数据类型。此外,CPC的增加与晚期肿瘤分期显着相关(ISSIII与ISSI-II:合并OR=2.89,95%CI:2.41-3.46,p<0.001;R-ISSIIIvs.R-ISSI-II:合并OR=3.65,95%CI:2.43-5.50,p<0.001)和高风险细胞遗传学(高风险与标准风险:OR=2.22,95%CI:1.60-3.08,p<0.001)。
■我们的荟萃分析证实,CPC数量的增加对MM患者的PFS和OS有负面影响。因此,CPC可能是一种有希望的预后生物标志物,有助于风险分层和疾病监测。
根据当前的研究状况,越来越需要更新的荟萃分析来确定CPC与MM预后之间的特定关系。我们的荟萃分析显示,高CPC水平与MM患者的OS和PFS恶化显著相关。CPC可能是一种有前途的预测性生物标志物,有助于风险分层和疾病监测。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
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.