Blood: Predicting prognosis for abnormal hematopoietic function in patients with new myeloma

Center point: about 1/10 of myeloma patientsshowed MDS-related phenotype abnormalities at diagnosis and had poor survivalMDS-related phenotype abnormalities alter the tumor microenvironment and can induce a higher risk of hematological toxicity during treatmentsummary of: the risk of myeloma hyperplasia syndrome (MDS) in patients with multiple myeloma (MM) and MGUS inhas increased significantly and is not related to treatmentHowever, the incidence and sequelae of hematopoietic dysfunction at the time of diagnosis are unknownresearchers used multi-dimensional flow cytomyphography (MFC) to study the clinical significance of single-nuclear cell-PA in 1,252 patients recruited in 285 MM patients recruited in THE PETHEMA/GEM2012MES65 trial (NCT01916252) in the forward-looking screening of bone marrowdiagnosed, 33 (11.6%) patients had MDS-PABulk and single-cell targeted sequencing of recurrent mutations of MDS gene in 67 patients with CD34-progenitor cells (and stunted spectrum) showed that 13/26 (50%) MDS-PA patients had cloned hematopoietic blood, 9/41 (22%) non-MDS-PA patients had cloned blood, and TET2 and NRAS were the most common mutant genesan assessment of MDS-PA dynamics at the time of diagnosis and after autologous transplantation found that in most cases (69/86, 80%), the presence or remainof in MDS-PA for a long timeIt is important to note that MDS-related mutations are rarely seen after high-dose treatmentBased on MFC analysis, the researchers also found changes in the hematopoietic and Treg distribution seconditiony and Treg in tumor microenvironments in patients with MDS-PAImportantly, the presence of mononucleosis MDS-PA at the time of diagnosis indicates a higher risk of hematotoxicity and is independently associated with poor progression-free survival and total survivalin general, this study reveals the biological and clinical significance of newly diagnosed hematopoietic dysfunction of multiple myeloma