Analysis Of The Relationship Between Immunophenotypic Expression And Prognosis In Patients With Newly Diagnosed Multiple Myeloma

Objective:To analyze the relationship between immunophenotypic expression,clinical related indexes and prognosis of(MM)patients with multiple myeloma in Affiliated Hospital of Yangzhou University retrospectively,so as to provide reference for the diagnosis,evaluation,prognosis judgement of MM in the future.Methods:Eighty-four patients with multiple myeloma who were newly diagnosed and treated in hematology department of Affiliated Hospital of Yangzhou University from January 2016 to December 2020 were analyzed retrospectively.The immunophenotypes of bone marrow abnormal plasma cells(myeloma cells)analyzed by multicolor flow cytometric,clinical characteristics and other laboratory related indexes were collected,and the treatment regimen and survival situation were calculated.According to the expression of immunophenotype,the groups were compared and statistically analyzed.Results:1.Clinical related indexes:(1)among the 84 patients with newly diagnosed MM in our hospital within 5 years,the ratio of male to female was 1.55:1,the median age of onset was 65 years old,the proportion of patients reaching stage Ⅲ was the highest(82.14%),and the proportion of IgG type was the most(47.62%).(2)univariate analysis showed that bone marrow plasma cell ratio,β 2-microglobulin(β2-MG),serum creatinine,DS stage,lactate dehydrogenase(LDH),neutrophil-to-lymphocyte ratio(NLR)and serum M protein were correlated with OS(P<0.05),while sex,age,M protein typing,serum uric acid,hemoglobin,D-dimer,corrected serum calcium and albumin(ALB)were not associated with OS.(3)Multivariate analysis showed that bone marrow plasma cell ratio,β2-MG,LDH and NLR were independent prognostic factors of OS in patients with MM(P<0.05),and all of them were negatively correlated with OS.2.Immunophenotyping related:(1)Immunophenotypic expression:CD20 positive(15.48%),CD45 positive(23.81%),CD19 positive(78.57%),CD81 positive(27.38%),CD56 positive(52.38%),CD117 positive(72.62%),CD200 positive(64.29%),CD27 positive(70.24%),CD28 positive(22.62%).(2)Univariate analysis showed that there was a positive correlation between CD19(+)、CD81(-)、CD56(+)、CD117(+)、CD27(+)、CD28(-)and OS separately(P<0.05),while CD20,CD45,CD200 were not associated with OS.Multivariate analysis showed that CD81 and CD56 were independent prognostic factors for OS,while CD81(-)and CD56(+)had better prognosis(P<0.05),and the 5-year survival rate was 86.9%and 93.2%.(3)Some immunophenotypes were selected for survival analysis.When combining CD117 and CD81 for analysis,the CD 117+CD81-group has the best prognosis(the 5-year survival rate was 95.45%),and the CD117-CD81+group has the worst(the 5-year survival rate was 33.33%);When combining CD 19 and CD56 for analysis,the CD 19+CD56+group has the best prognosis(the 5-year survival rate was 97.1%),and the CD19-CD56-group has the worst(the 5-year survival rate was 25%);When combining CD56 and CD45 for analysis,the CD56+CD45+group has the best prognosis(the 5-year survival rate was 100%),and the CD56-CD45-group has the worst(the 5-year survival rate was 67.74%);When combining CD117 and CD28 for analysis,the CD117+CD28-group has the best prognosis(the 5-year survival rate was 92.45%),and the CD117-CD28+group has the worst(the 5-year survival rate was 18.18%)(P<0.05);(4)The albumin index of CD45(-)was lower than that of CD45(+)patients,the hemoglobin index of CD 19(+)patients was higher than that of CD 19(-)patients,the bone marrow plasma cell ratio,β2-MG and CRP index of CD200(-)patients were higher than that of CD200(+)patients,and the NLR of CD27(+)patients was lower than that of CD27(-)patients.The expression of CD45,CD 19,CD200 and CD27 had no significant relevance with other indexes.There was no significant correlation between the expression of CD20,CD81,CD56,CD117,and CD28 and the level of clinical indexes.Conclusion:1.In the past 5 years,the median age of onset of MM patients in hematology department of Affiliated Hospital of Yangzhou University was 65 years old.Males were slightly more common than females,and the proprtion of stage Ⅲ IgG patients was the most.The bone marrow plasma cell ratio,β2-MG,serum creatinine,DS stage,LDH,NLR and serum M protein were correlated with OS,and the bone marrow plasma cell ratio,β2-MG,LDH and NLR were negatively correlated with OS in patients with MM,which were independent prognostic factors;2.The expressions of CD19(+),CD81(-),CD56(+),CD117(+),CD27(+),CD28(-)were positively correlated with OS,and CD81(-)and CD56(+)were independent good prognostic factors;when combined CD117 and CD81 analysis,CD117+CD81-group had the best prognosis;CD19 and CD56 combined analysis,CD19+CD56+group had the best prognosis;CD56 and CD45 combined analysis,CD56+CD45+group had the best prognosis;CD117 and CD28 combined analysis,CD117+CD28-group had the best prognosis;3.The albumin index of CD45(-)was lower than that of CD45(+)patients.The hemoglobin index of CD 19(+)patients was higher than that of CD 19(-)patients.The patients with CD200(+)were more likely to have poor prognosis such as high bone marrow plasma cell ratio,high β 2-MG and high CRP index than those with CD200(-).and the inflammatory index NLR of CD27(+)patients was lower than that of CD27(-)patients.The expression of residual immunophenotype was not related to clinical features.