RELATIONSHIP OF CD27, CD28, CD81, AND CD117 MARKERS WITH TREATMENT RESPONSE AND PROGNOSIS IN MULTIPLE MYELOMA

Öz

 Objective: This study aimed to evaluate the relationship between CD27, CD28, CD81, and CD117 antigens and clinical, biochemical, and cytogenetic parameters in patients with multiple myeloma (MM) and to evaluate their prognostic significance.

Material and Methods: A retrospective analysis was performed on data from 100 multiple myeloma patients. The analysis included available flow cytometry data (CD27, CD28, CD81, and CD117) and bone marrow biopsy results. Demographic data, laboratory parameters, cytogenetic analyses, treatment responses, and mortality were recorded. Multivariate logistic regression analysis was performed for variables associated with the R-ISS stages. 

Results: The median age of the patients was 67 years, and 64% were men. The positivity rates for CD27, CD28, CD81, and CD117 were 45%, 53%, 61%, and 51%, respectively. As the R-ISS stage increased, CD27 negativity significantly increased (p=0.021), while CD117 positivity also increased (p=0.046). In the multivariate analysis, CD28 positivity emerged as an independent risk factor for a higher R-ISS stage (aOR=0.324 for CD28 negativity, p=0.015). CKS1B positivity (p=0.039) and a high bone marrow plasma cell ratio (p=0.004) were independently associated with advanced disease stages. As the R-ISS stage increased, ECOG performance scores worsened, and the number of lytic lesions and mortality rates significantly increased. 

Conclusion: In multiple myeloma, CD27 loss and CD117 positivity are associated with poor prognosis, whereas CD28 positivity is associated with more advanced disease stage. The addition of these immunophenotypic markers to the R-ISS classification may contribute to a more accurate assessment of biological risk and the development of personalized treatment plans.

Anahtar Kelimeler

• Multiple Myeloma
• CD27 Antigen
• CD28 Antigen
• CD117 Antigen
• Prognosis
• Flow Cytometry

Multipl Miyelomda CD27, CD28, CD81 ve CD117 Belirteçlerinin Tedavi Yanıtı ve Prognoz ile İlişkisi

Öz

 Amaç: Bu çalışmada, multipl miyelomalı (MM) hastalarda CD27, CD28, CD81 ve CD117 antijenlerinin klinik, biyokimyasal ve sitogenetik parametrelerle ilişkisi ve prognostik öneminin değerlendirilmesi amaçlanmıştır. 

Gereç ve Yöntemler: Yüz multipl miyelom hastasının verileri üzerinde retrospektif bir analiz yapıldı. Analize, mevcut akış sitometrisi verileri (CD27, CD28, CD81 ve CD117) ve kemik iliği biyopsi sonuçları dahil edildi. Demografik veriler, laboratuvar parametreleri, sitogenetik analizler, tedavi yanıtı ve mortalite durumları kaydedildi. R-ISS evreleriyle ilişkili değişkenler için çok değişkenli lojistik regresyon analizi yapıldı. 

Bulgular: Hastaların medyan yaşı 67 yıl, %64’ü erkekti. CD27, CD28, CD81 ve CD117 pozitiflik oranları sırasıyla %45, %53, %61 ve %51 olarak bulundu. R-ISS evresi arttıkça CD27 negatifliği anlamlı biçimde artarken (p=0,021), CD117 pozitifliği de yükseldi (p=0,046). Çok değişkenli analizde, CD28 pozitifliği, daha yüksek bir R-ISS evresi için bağımsız bir risk faktörü olarak ortaya çıktı (CD28 negatifliği için aOR=0,324, p=0,015). CKS1B pozitifliği (p=0,039) ve yüksek kemik iliği plazma hücresi oranı (p=0.004) ileri evrelerle bağımsız ilişkiliydi. R-ISS evresi arttıkça ECOG performans skoru kötüleşti, litik lezyon sayısı ve mortalite oranı belirgin şekilde arttı. 

Sonuç: Multipl miyelomda, CD27 kaybı ve CD117 pozitifliği kötü prognozla ilişkili iken, CD28 pozitifliği daha ileri hastalık evresiyle ilişkilidir .Bu immünofenotipik belirteçlerin R-ISS sınıflamasına eklenmesi, biyolojik riskin daha doğru değerlendirilmesine ve kişiselleştirilmiş tedavi planlamalarının geliştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

• Multipl Miyelom
• CD27 Antijeni
• CD28 Antijeni
• CD117 Antijeni
• Prognoz
• Akım Sitometrisi

Kaynakça

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