Therapeutic efforts to maintain an intact immune system may be crucial in maximizing chemotherapeutic and/or immunotherapy efforts in this disease.ĮCOG trial 9486, a multicenter trial conducted as both a clinical and correlative laboratory protocol, has been previously described. In addition, the importance of the CD19 + blood cells to survival is evident throughout the course of MM. This latter data affirms the positive relationship between the quantitative status of the blood immune system in MM and survival. Patients with MM had evidence of immune cell reconstitution after 2 years of therapy, but the rate and extent of recovery was greater for CD8 +, which was greater than CD4 +, which was greater than CD19 +. Higher CD19 + blood levels were positively associated with MM-patient survival at entry to the study, at year 2, and at relapse ( P < .0001 at all 3 timepoints). A multivariate analysis incorporating CD4 + and CD19 + cell levels defined 3 separate groups of patients with MM to survival outcome. Baseline CD3 +, CD4 +, CD8 +, CD19 +, and CD4 + subset cell levels were all positively associated with survival ( P = .0087 to P < .0001). Blood immune cell levels were studied at trial entry (baseline), after 2 cycles of chemotherapy, after 2 years of therapy, and at relapse. Newly diagnosed patients with MM received 2 cycles of vincristine, bischloroethylnitrosourea, melphalan, cytoxan, prednisone (VBMCP) and were treated on one of 3 randomized arms: VBMCP with either interferon or high-dose cyclophosphamide, or VBMCP alone.

This article extends the analysis of immune cell levels and survival in a large cohort (N = 504) of patients with MM entered on Eastern Cooperative Oncology Group (ECOG) phase 3 trial (9486). Previously, it was reported that patients with multiple myeloma (MM) who have higher baseline levels of blood CD4 +or CD19 + cells have longer survival.

Lab still alive 1.23 download