Tregs at Diagnosis as a Potential Biomarker for Predicting High-Risk Functionality in Newly Diagnosed Multiple Myeloma.

OBJECTIVE: This study investigated the role of regulatory T cells (Tregs) in newly diagnosed multiple myeloma (NDMM) patients, particularly in relation to early relapse and prognosis. METHODS: The analysis included clinical data from 70 NDMM patients, with Tregs measured at diagnosis. Early relapse was defined as relapse within 18 months (ER18), and posttransplant survival extending beyond 12 months. Functional high risk (FHR) was evaluated based on this criterion. RESULTS: For the overall cohort, the median progression-free survival (PFS) and overall survival (OS) were not reached, but in the ER18 cohort, median OS was 24.8 months and median PFS was 10.8 months. Key factors linked to early relapse included elevated serum creatinine levels (> 156 μmol/L), presence of extramedullary disease, and lower percentage of Tregs at diagnosis. Multivariate analysis revealed that extramedullary disease and lower percentage of Tregs were significant predictors of early relapse. Factors such as age, elevated creatinine, extramedullary disease, and lower percentage of Tregs were associated with poorer PFS. Further analysis confirmed that extramedullary lesions, elevated creatinine, and lower percentage of Tregs significantly influenced PFS. CONCLUSION: Overall, Tregs at diagnosis were found to be important for predicting early relapse and progression-free survival, highlighting their potential as a biomarker for functional high risk in multiple myeloma.