Dr. Sklavenitis-Pistofidis on Single-Cell Dissection of Immune Cells in Smoldering Myeloma

Romanos Sklavenitis-Pistofidis, MD, postdoctoral fellow, Michele and Steven Kirsch Laboratory, Dana-Farber Cancer Institute, discusses single-cell dissection of bone marrow and peripheral blood immune cells in smoldering multiple myeloma.

Researchers used single-cell dissection of bone marrow and peripheral blood immune cells in a large cohort of patients with smoldering multiple myeloma to examine changes at diagnosis and post-therapy.

Findings presented at the 19th International Myeloma Society Annual Meeting showed that significant changes were detected in the immune-cell composition of patients with smoldering multiple myeloma compared with healthy donors, Sklavenitis-Pistofidis says. Increases were observed in CD4-positive T cells, granzyme B–expressing cytotoxic T cells, and CD56dim natural killer cells. Additionally, decreases were seen in plasmacytoid dendritic cells and CD14-positive monocytes, Sklavenitis-Pistofidis explains.

Notably, patients with immune-cell composition most similar to that of healthy donors had worse outcomes, and patients who were less normal at baseline achieved significantly longer progression-free survival (PFS), Sklavenitis-Pistofidis continues. This condition has been coined immune reactivity, Sklavenitis-Pistofidis adds.

Moreover, a normalization score created by investigators increased on average between baseline and end of treatment throughout 2 years of therapy, Sklavenitis-Pistofidis says. The normalization score can be used to classify patients into those who achieved post-therapy immune normalization and those who did not, Sklavenitis-Pistofidis explains. Patients who achieved post-therapy immune normalization had significantly longer PFS, Sklavenitis-Pistofidis concludes.