ArticleHaematologica2026
Phenotypic evolution of circulating plasma cells from early precursor stages to multiple myeloma.
Article in Haematologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Circulating tumor plasma cells (CTPC) have emerged as valuable diagnostic and prognostic marker in multiple myeloma (MM), with their presence linked to progression from precursor stages and poorer outcomes in newly diagnosed MM (NDMM). While quantitative CTPC enumeration is increasingly validated, comprehensive phenotypic profiling across disease stages remains lacking. We applied 36-parameter spectral flow cytometry to 113 peripheral blood mononuclear cell samples of monoclonal gammopathy of undetermined significance (N=42), smouldering MM (N=22), NDMM (N=15), treated MM (N=24), and healthy controls (N=10), alongside paired bone marrow (BM) samples from six NDMM patients. CTPC were defined phenotypically as CD45-CD38highCD56+ events without assessment of clonality. Phenotypic profiling of the CD56+ CTPC-like subset across disease stages revealed alterations in canonical and lineage-atypical surface markers. Progression to NDMM was characterized by upregulation of CD38 and CD56 with concomitant loss of B- (CD19), myeloid- (CD14, CD16), and T-cell-associated (CD45RA) markers. In addition, HLA-ABC, interleukin receptor subunits (CD25, CD123), and chemokine receptors (CCR6, CCR7) were upregulated in NDMM. In treated MM, a reversed pattern was observed with lower CD25 and CD123 expression and increased levels of exhaustion markers (TIGIT, PD-1). Paired BM samples showed a different tissue-residency marker expression, characterized by higher CD69 and CCR6 and lower CD138, along with changes in cell-survival related markers, including increased CD25 and CD123. Both BCMA and CD307e were more highly expressed on BM plasma cells than CTPC. This study is among the first to provide a comprehensive phenotypic characterization of CD56+ CTPC across the MM spectrum, including checkpoint and chemokine receptors, treated disease cases, and paired BM samples for NDMM.
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