异常浆细胞CD56表达与多发性骨髓瘤临床特征及化疗疗效的关系OA

Objective To explore the relationship between the expression of CD56 on the surface of abnormal plasma cells and clinical characteristics and therapeutic effects before chemotherapy with bortezomib,lenalidomide combined with dexamethasone in patients with multiple myeloma(MM).Methods A total of 88 MM patients admitted to our hospital from January 2023 to December 2025 were selected.All patients underwent chemotherapy with 28 days as one course for a total of 3 courses.Collect the M protein type,clinical stage,light chain type and IgH rearrangement of the patients.Stratified regression was used to analyze the relationship between clinical features and the expression of CD56+on the surface of abnormal plasma cells before chemotherapy.The independent factors influencing the treatment impact were examined using multivariate logistic regression.The causal relationship between the percentage of CD56 cells and the effectiveness of MM patients was examined using the breakpoint regression design(RDD),and the percentage of CD56 cells on the surface of abnormal plasma cells was analyzed for its predictive value for the prognosis of MM patients using the area under the receiver operating characteristic curve(ROC-AUC).Results According to the effect after chemotherapy,they were divided into the effective group(n=56)and the ineffective group(n=32).Multivariate binary logistic regression analysis showed that IgA type(OR=1.26,P=0.01),IgD type(OR=2.15,P＜0.001),clinical stage Ⅱ(OR=1.54,P=0.01),stage Ⅲ(OR=2.23,P＜0.001),λ light chain type(OR=1.85,P＜0.001),and negative IgH rearrangement(OR=0.14,P=0.03)were all independent factors influencing CD56+expression.The proportions of hypercalcemia,anemia and bleeding,high-viscosity syndrome,β2-microglobulin(β2-MG),and CD56+in the ineffective group were higher than those in the effective group,and the differences were statistically significant(P＜0.05).The multivariate Logistic regression analysis showed that the higher the clinical stage(OR=2.48),hypercalcemia(OR=5.06),anemia and bleeding(OR=1.36),high-viscosity syndrome(OR=5.15),elevated β2-MG(OR=3.49),and CD56+(OR=3.13)were independent risk factors for ineffective treatment(P＜0.05).The RDD analysis showed that when the percentage of CD56 cells was 29％,the probability of effective treatment for MM decreased by 5.16％(P=0.01).The ROC analysis showed that the percentage of CD56 cells had moderate predictive value for the efficacy of MM(AUC＞0.70),and the predictive value was higher in patients aged ≥ 60 years,female,and stage Ⅲ(AUCs were 0.82,0.81,and 0.81,respectively).Conclusion The expression of CD56+on the surface of abnormal plasma cells before chemotherapy was significantly correlated with the M protein type,clinical stage,light chain type and IgH rearrangement of MM.The expression of CD56+could effectively predict the therapeutic effect,and CD56 could be used as a prognostic marker in clinical practice.