open access

Vol 53, No 6 (2022)
Original research article
Submitted: 2021-11-05
Accepted: 2022-05-23
Published online: 2022-10-02
Get Citation

Prognostic value of B-cell maturation antigen, CD56 expression and neutrophil lymphocyte ratio in patients with multiple myeloma

Mona Saied Fadilah1, Hala Kassem Sultan1, Maha Mohamed Adel El-Gammal1, Ola Ali Balbaa1, Amel Ali El-Naggar1
DOI: 10.5603/AHP.a2022.2046
·
Acta Haematol Pol 2022;53(6):386-391.
Affiliations
  1. Department of Hematology, Medical Research Institute, Alexandria University, Alexandria, Egypt

open access

Vol 53, No 6 (2022)
ORIGINAL RESEARCH ARTICLE
Submitted: 2021-11-05
Accepted: 2022-05-23
Published online: 2022-10-02

Abstract

Introduction: B-cell maturation antigen (BCMA) plays a critical role in regulating B-cell proliferation and differentiation into plasma cells. CD56 is involved in the adhesion of myeloma cells to the bone marrow matrix. Thus, lack of CD56 expression is associated with a higher incidence of extramedullary disease. An elevated neutrophil-lymphocyte ratio (NLR) has been recognized as a poor prognostic factor in various hematological malignancies.
The aim of this study was to evaluate the role of BCMA, CD56 and NLR as novel prognostic markers in multiple myeloma (MM).
Material and methods: The study included 80 subjects, 40 MM patients, and 40 normal healthy age- and sex-matched controls. BCMA was analyzed by enzyme-linked immune sorbent assay. Flow cytometry was used for the determination of CD56 expression. NLR was calculated from the complete blood count differential count. All patients received six cycles of bortezomib, cyclophosphamide and dexamethasone (VCD). Treatment outcome was assessed and progression-free survival (PFS) was estimated using Kaplan-Meier survival analysis.
Results: Patients who achieved complete remission showed lower BCMA levels, positive CD56 expression, and lower NLR. Moreover, higher BCMA levels and CD56 negative expression were significantly associated with shorter PFS.
Conclusions: Our study emphasizes the importance of BCMA, CD56 and   NLR to predict the clinical outcome in MM patients. This could help in better risk stratification and tailored clinical management of MM patients.

Abstract

Introduction: B-cell maturation antigen (BCMA) plays a critical role in regulating B-cell proliferation and differentiation into plasma cells. CD56 is involved in the adhesion of myeloma cells to the bone marrow matrix. Thus, lack of CD56 expression is associated with a higher incidence of extramedullary disease. An elevated neutrophil-lymphocyte ratio (NLR) has been recognized as a poor prognostic factor in various hematological malignancies.
The aim of this study was to evaluate the role of BCMA, CD56 and NLR as novel prognostic markers in multiple myeloma (MM).
Material and methods: The study included 80 subjects, 40 MM patients, and 40 normal healthy age- and sex-matched controls. BCMA was analyzed by enzyme-linked immune sorbent assay. Flow cytometry was used for the determination of CD56 expression. NLR was calculated from the complete blood count differential count. All patients received six cycles of bortezomib, cyclophosphamide and dexamethasone (VCD). Treatment outcome was assessed and progression-free survival (PFS) was estimated using Kaplan-Meier survival analysis.
Results: Patients who achieved complete remission showed lower BCMA levels, positive CD56 expression, and lower NLR. Moreover, higher BCMA levels and CD56 negative expression were significantly associated with shorter PFS.
Conclusions: Our study emphasizes the importance of BCMA, CD56 and   NLR to predict the clinical outcome in MM patients. This could help in better risk stratification and tailored clinical management of MM patients.

Get Citation

Keywords

BCMA, CD56, neutrophil-lymphocyte ratio, myeloma

About this article
Title

Prognostic value of B-cell maturation antigen, CD56 expression and neutrophil lymphocyte ratio in patients with multiple myeloma

Journal

Acta Haematologica Polonica

Issue

Vol 53, No 6 (2022)

Article type

Original research article

Pages

386-391

Published online

2022-10-02

Page views

1120

Article views/downloads

95

DOI

10.5603/AHP.a2022.2046

Bibliographic record

Acta Haematol Pol 2022;53(6):386-391.

Keywords

BCMA
CD56
neutrophil-lymphocyte ratio
myeloma

Authors

Mona Saied Fadilah
Hala Kassem Sultan
Maha Mohamed Adel El-Gammal
Ola Ali Balbaa
Amel Ali El-Naggar

References (30)
  1. Iriuchishima H, Saitoh T, Handa H, et al. A new staging system to predict prognosis of patients with multiple myeloma in an era of novel therapeutic agents. Eur J Haematol. 2015; 94(2): 145–151.
  2. Kumar SK, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008; 111(5): 2516–2520.
  3. van de Donk NW, Moreau P, Plesner T, et al. Clinical efficacy and management of monoclonal antibodies targeting CD38 and SLAMF7 in multiple myeloma. Blood. 2016; 127(6): 681–695.
  4. Solimando AG, Da Vià MC, Cicco S, et al. High-Risk multiple myeloma: integrated clinical and omics approach dissects the neoplastic clone and the tumor microenvironment. J Clin Med. 2019; 8(7).
  5. Ghermezi M, Li M, Vardanyan S, et al. Serum B-cell maturation antigen: a novel biomarker to predict outcomes for multiple myeloma patients. Haematologica. 2017; 102(4): 785–795.
  6. Hansen CT, Pedersen PT, Nielsen LC, et al. Evaluation of the serum free light chain (sFLC) analysis in prediction of response in symptomatic multiple myeloma patients: rapid profound reduction in involved FLC predicts achievement of VGPR. Eur J Haematol. 2014; 93(5): 407–413.
  7. Jacobs JFM, Tate JR, Merlini G. Is accuracy of serum free light chain measurement achievable? Clin Chem Lab Med. 2016; 54(6): 1021–1030.
  8. Dogan A, Siegel D, Tran N, et al. B-cell maturation antigen expression across hematologic cancers: a systematic literature review. Blood Cancer J. 2020; 10(6): 73.
  9. Hundemer M, Klein U, Hose D, et al. Lack of CD56 expression on myeloma cells is not a marker for poor prognosis in patients treated by high-dose chemotherapy and is associated with translocation t(11;14). Bone Marrow Transplant. 2007; 40(11): 1033–1037.
  10. Skerget M, Skopec B, Zadnik V, et al. CD56 expression is an important prognostic factor in multiple myeloma even with bortezomib induction. Acta Haematol. 2018; 139(4): 228–234.
  11. Szudy-Szczyrek A, Mlak R, Mielnik M, et al. Prognostic value of pretreatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in multiple myeloma patients treated with thalidomide-based regimen. Ann Hematol. 2020; 99(12): 2881–2891.
  12. Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106(6): dju124.
  13. Rajkumar S, Dimopoulos M, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15(12): e538–e548.
  14. Moreau P, Miguel JS, Ludwig H, et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24: vi133–vi137.
  15. Bates I. Bone marrow biopsy. In: Bain BJ, Lewis SM, Bates I. ed. Dacie and Lewis practical hematology. Churchill Livingstone Elsevier, Philadelphia 2017: 112–125.
  16. Sanchez E, Li M, Kitto A, et al. Serum B-cell maturation antigen is elevated in multiple myeloma and correlates with disease status and survival. Br J Haematol. 2012; 158(6): 727–738.
  17. Lee L, Bounds D, Paterson J, et al. Evaluation of B cell maturation antigen as a target for antibody drug conjugate mediated cytotoxicity in multiple myeloma. Br J Haematol. 2016; 174(6): 911–922.
  18. Kelkitli E, Atay H, Cilingir F, et al. Predicting survival for multiple myeloma patients using baseline neutrophil/lymphocyte ratio. Ann Hematol. 2014; 93(5): 841–846.
  19. Zuo H, Zhai L, Liu Xu, et al. Prognostic significance of neutrophil-lymphocyte ratio in multiple myeloma patients. Transl Cancer Res. 2018; 7(1): 88–96.
  20. Shi L, Qin X, Wang H, et al. Elevated neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio and decreased platelet-to-lymphocyte ratio are associated with poor prognosis in multiple myeloma. Oncotarget. 2017; 8(12): 18792–18801.
  21. Romano A, Parrinello NL, Consoli ML, et al. Neutrophil to lymphocyte ratio (NLR) improves the risk assessment of ISS staging in newly diagnosed MM patients treated upfront with novel agents. Ann Hematol. 2015; 94(11): 1875–1883.
  22. Zhou X, Wang J, Xia J, et al. Evaluation of neutrophil-to-lymphocyte ratio in newly diagnosed patients receiving borte- zomib-based therapy for multiple myeloma. Cancer Biomark. 2018; 22(1): 43–48.
  23. Ceran F, Falay M, Dağdaş S, et al. The assessment of CD56 and CD117 expressions at the time of the diagnosis in multiple myeloma patients. Turk J Haematol. 2017; 34(3): 226–232.
  24. Sanchez E, Gillespie A, Tang G, et al. Soluble B-cell maturation antigen mediates tumor-induced immune deficiency in multiple myeloma. Clin Cancer Res. 2016; 22(13): 3383–3397.
  25. Li Y, Li H, Li W, et al. Pretreatment neutrophil/lymphocyte ratio but not platelet/lymphocyte ratio has a prognostic impact in multiple myeloma. J Clin Lab Anal. 2017; 31(5).
  26. Jew S, Chang T, Bujarski S, et al. Normalization of serum B-cell maturation antigen levels predicts overall survival among multiple myeloma patients starting treatment. Br J Haematol. 2021; 192(2): 272–280.
  27. Pan Y, Wang H, Tao Q, et al. Absence of both CD56 and CD117 expression on malignant plasma cells is related with a poor prognosis in patients with newly diagnosed multiple myeloma. Leuk Res. 2016; 40: 77–82.
  28. Yoshida T, Ri M, Kinoshita S, et al. Low expression of neural cell adhesion molecule, CD56, is associated with low efficacy of bortezomib plus dexamethasone therapy in multiple myeloma. PLoS One. 2018; 13(5): e0196780.
  29. Zeng Q, Liu Z, Li Q, et al. Prognostic value of neutrophil to lymphocyte ratio and clinicopathological characteristics for multiple myeloma: A meta-analysis. Medicine (Baltimore). 2018; 97(41): e12678.
  30. Lee GW, Park S, Go SI, et al. The derived neutrophil-to-lymphocyte ratio is an independent prognostic factor in transplantation ineligible patients with multiple myeloma. Acta Haematol. 2018; 140(3): 146–156.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl