PD-L1 expression in bone marrow plasma cells as a biomarker to predict multiple myeloma prognosis: developing a nomogram-based prognostic model

Byung Hyun Lee, Yong Park, Ji Hye Kim, Ka Won Kang, Seung Jin Lee, Seok Jin Kim, Byung Soo Kim

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24 Citations (Scopus)

Abstract

PD-L1 expression is associated with poor prognosis, although this relationship is unclear in bone marrow-derived haematologic malignancies, including multiple myeloma. We aimed to determine whether PD-L1 expression could predict the prognosis of newly diagnosed multiple myeloma (NDMM). We evaluated 126 NDMM patients (83, retrospectively; 43, prospectively) who underwent bone marrow examinations. Bone marrow aspirates were analysed for PD-L1 expression, categorized as low or high expression, using quantitative immunofluorescence. High PD-L1 expression could independently predict poor overall survival (OS) (95% CI = 1.692–8.346) in multivariate analysis. On subgroup analysis, high PD-L1 expression was associated with poor OS (95% CI = 2.283–8.761) and progression-free survival (95% CI = 1.024–3.484) in patients who did not undergo autologous stem cell transplantation (ASCT) compared with those who did. High PD-L1 expression was associated with poor OS despite frontline treatments with or without immunomodulators. Thus, PD-L1 expression can be a useful prognosis predictor in NDMM patients, whereas ASCT may be used in patients with high PD-L1 expression. We developed a prognostic nomogram and found that a combination of PD-L1 expression in bone marrow plasma cells and clinical parameters (age, cytogenetics, and lactate dehydrogenase) effectively predicted NDMM prognosis. We believe that our nomogram can help identify high-risk patients and select appropriate treatments.

Original languageEnglish
Article number12641
JournalScientific reports
Volume10
Issue number1
DOIs
Publication statusPublished - 2020 Dec 1

Bibliographical note

Funding Information:
The authors thank the following members of the Korea University Anam Hospital Clinical Trial Center: Jin Wha Lee for help with collecting the clinical data, Chan Min Lee for the preparation of the bone marrow samples, and Jimi Choi for helpful advice and support with the statistical analysis. The authors also thank Seung-Yeon Oh for technical support with the immunofluorescence analysis. This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation, which is funded by the Ministry of Science & ICT [2017M3A9C8060403].

Publisher Copyright:
© 2020, The Author(s).

ASJC Scopus subject areas

  • General

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