ArticleBlood cancer journal2025
Clonal plasma cell proportion in the synthetic phase identifies a unique high-risk cohort in multiple myeloma.
Article in Blood cancer journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Predictors of posttransplant measurable residual disease negativity and impact on clinical outcomes in multiple myeloma.Blood advances · 2026Article
- Metabolic heterogeneity and niche rewiring in bone marrow plasma cells from patients with MGUS, solitary bone plasmacytoma and multiple myeloma.Blood cancer journal · 2026Article
- Metabolic Heterogeneity and Niche Rewiring in Plasma Cells are Associated with Progression from MGUS to Multiple Myeloma.Research square · 2026Article
- Elevated non-clonal bone marrow plasma cell fraction at diagnosis is associated with improved outcomes in multiple myeloma.Blood cancer journal · 2026Article
- Single-cell RNA sequencing analysis revealed a potential association between ELK3 expression and the progression of multiple myeloma.Frontiers in immunology · 2026Article
- Concordant Shared Transcriptomic Signatures and Candidate Regulatory Features in Chronic Lymphocytic Leukemia and Multiple Myeloma.Oncology research · 2026Article
- Defining High-Risk Disease Biology in Multiple Myeloma: A Narrative Review.Blood and lymphatic cancer : targets and therapy · 2026Review
- Impact of t(11;14) primary cytogenetic abnormality and the cumulative effect of multiple high-risk cytogenetics at diagnosis on the outcomes of patients with primary plasma cell leukemia.Blood cancer journal · 2025Article
- Current risk stratification and staging of multiple myeloma and related clonal plasma cell disorders.Leukemia · 2025Review
- Impact of residual clonal plasma cells in S-phase at the time of autologous stem cell transplantation on clinical outcomes.Blood cancer journal · 2025Article
- Elevated circulating tumor cells reflect high proliferation and genomic complexity in multiple myeloma.HemaSphere · 2025Article
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28 authors.
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Abstract
Risk stratification models based on cytogenetics and disease burden help identify high-risk patients with newly diagnosed multiple myeloma (NDMM). However, some high-risk patients remain undetected. This study evaluated the prognostic utility of the proportion of clonal plasma cells in the S-phase of the cell cycle for NDMM. Patients with active multiple myeloma diagnosed between 01/01/2013 and 01/31/2023 who underwent S-phase assessment were included. The S-phase proportion was calculated by analyzing DNA content between G0/G1 and G2/M peaks. Among 823 patients, 16% (135) had S-phase ≥2% at diagnosis. Patients with S-phase ≥2% exhibited significantly worse median progression-free survival (PFS) of 1.4 years (95% CI: 1.2-1.9) compared to 2.9 years (95% CI: 2.6-3.3) for those with S-phase <2% (HR 1.6, p < 0.0001). Median overall survival (OS) was also significantly lower at 3.9 years (95% CI: 2.9-5.7) versus 9.2 years (95% CI: 7.9-not reached; HR 2.2, p < 0.0001). Multivariate analysis confirmed S-phase ≥2% as an independent predictor of inferior PFS (HR 1.56, p = 0.001) and OS (HR 2, p < 0.0001) after adjusting for R2-ISS risk, age, renal function, and treatment strategies. Among patients with S-phase ≥2%, 53% (68/129) experienced progression-free survival (PFS) under 18 months with upfront therapy. Elevated S-phase was associated with a 2.5-fold higher risk of progression within 18 months [OR 2.55 (95% CI: 1.7-3.7), p < 0.001]. Patients with elevated S-phase but no IMS-high risk had a median OS of 5.7 years (95% CI: 4.7-9.2), similar to the IMS-high risk cohort without elevated S-phase (5.4 years, 95% CI: 4-NR). Those with both elevated S-phase and IMS-high risk had significantly worse OS (3.1 years, 95% CI: 1.6-NR, p = 0.043). These findings suggest that S-phase ≥2% is a powerful, independent prognostic marker for NDMM.
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