RT Journal Article
T1 Immune status of high-risk smoldering multiple myeloma patients and its therapeutic modulation under LenDex: a longitudinal analysis.
A1 Paiva, Bruno
A1 Mateos, María Victoria
A1 Sanchez-Abarca, Luis Ignacio
A1 Puig, Noemi
A1 Vidriales, María-Belén
A1 López-Corral, Lucía
A1 Corchete, Luis A
A1 Hernandez, Miguel T
A1 Bargay, Joan
A1 de Arriba, Felipe
A1 de la Rubia, Javier
A1 Teruel, Ana-Isabel
A1 Giraldo, Pilar
A1 Rosiñol, Laura
A1 Prosper, Felipe
A1 Oriol, Albert
A1 Hernández, José
A1 Esteves, Graça
A1 Lahuerta, Juan José
A1 Bladé, Joan
A1 Perez-Simon, Jose Antonio
A1 San Miguel, Jesús F
A1 Spanish Myeloma Group / Program Study and Treatment of Hematological Malignancies cooperative study groups, 
AB There is significant interest in immunotherapy for the treatment of high-risk smoldering multiple myeloma (SMM), but no available data on the immune status of this particular disease stage. Such information is important to understand the interplay between immunosurveillance and disease transformation, but also to define whether patients with high-risk SMM might benefit from immunotherapy. Here, we have characterized T lymphocytes (including CD4, CD8, T-cell receptor γδ, and regulatory T cells), natural killer (NK) cells, and dendritic cells from 31 high-risk SMM patients included in the treatment arm of the QUIREDEX trial, and with longitudinal peripheral blood samples at baseline and after 3 and 9 cycles of lenalidomide plus low-dose dexamethasone (LenDex). High-risk SMM patients showed at baseline decreased expression of activation-(CD25/CD28/CD54), type 1 T helper-(CD195/interferon-γ/tumor necrosis factor-α/interleukin-2), and proliferation-related markers (CD119/CD120b) as compared with age-matched healthy individuals. However, LenDex was able to restore the normal expression levels for those markers and induced a marked shift in T-lymphocyte and NK-cell phenotype. Accordingly, high-risk SMM patients treated with LenDex showed higher numbers of functionally active T lymphocytes. Together, our results indicate that high-risk SMM patients have an impaired immune system that could be reactivated by the immunomodulatory effects of lenalidomide, even when combined with low-dose dexamethasone, and support the value of therapeutic immunomodulation to delay the progression to multiple myeloma. The QUIREDEX trial was registered to www.clinicaltrials.gov as #NCT00480363.
YR 2015
FD 2015-12-14
LK http://hdl.handle.net/10668/9664
UL http://hdl.handle.net/10668/9664
LA en
DS RISalud
RD Jun 4, 2025