According to research published in the Journal of Clinical Medicine, elevated CD24 expression on plasma cells was strongly correlated with survival and may be used as a single-surface antigenic prognostic factor in multiple myeloma (MM).
“In a previous study, we showed that in-vitro, CD24-positive plasma cells exhibit a less tumorigenic phenotype,” the researchers wrote in their report. “Here, we assessed the prognostic importance of CD24 expression in patients newly diagnosed with MM as it correlates to their clinical course.”
The research team retrospectively analyzed data and samples from 124 patients with newly diagnosed MM or primary amyloidosis who were treated at Hadassah Medical Center, Jerusalem, Israel, between September 2011 and June 2017. The cohort had a higher proportion of males (60.5%) than females (39.5%), and the median age was 62.5 years (range, 30-89). All patients were treated using a bortezomib-based protocol.
The researchers evaluated the expression of CD24, CD117, CD19, CD45, and CD56 on bone marrow plasma cells using flow cytometry and tested for correlations with clinical parameters, including baseline patient and disease characteristics at diagnosis, treatment protocol, response to treatment, and long-term outcomes.
The team demonstrated that expression patterns of the CD markers varied with different clonal evolutionary stages of MM development. None of the markers were correlated with response rates to first-line therapy. Patients with elevated CD24+ expression (>5%) on their plasma cells at diagnosis had significantly longer progression-free survival (PFS; P =.002) and overall survival (OS; P =.044) than those with lower CD24+ expression (≤5%). The researchers found that CD19 expression was inversely correlated with PFS (P <.001) but not with OS. None of the other markers (CD117, CD56, or CD45) had prognostic value.
“Elevated CD24 expression correlated with better prognosis,” concluded the researchers. “This finding, combined with the known and validated prognostic factors, can provide a more extensive specific prognostic assessment profile of individual patients.”
Limitations of the study included the retrospective design, some missing data, exclusion of patients treated with non-bortezomib-based induction protocols, changing treatment paradigms (including newer agents for the relapse setting) in MM during the study period, and use of predominantly 4-color flow cytometry.
Gross Even-Zohar N, Pick M, Hofstetter L, et al. CD24 is a prognostic marker for multiple myeloma progression and survival. J Clin Med. 2022;11(10):2913. Published May 20, 2022. doi:10.3390/jcm11102913