Prognostic Value of Association of Copy Number Alterations and Cell-Surface Expression Markers in Newly Diagnosed Multiple Myeloma Patients.

Multiple myeloma results from the clonal proliferation of abnormal plasma cells (PCs) in the bone marrow (BM). In this study, the cell surface expression markers (CD) on atypical PCs (detected by multiparametric flow cytometry (MFC)) were correlated with copy number alterations (CNAs) in the genome (detected by multiplex ligation-dependent probe amplification (MLPA)) to assess their impact on prognosis in newly diagnosed MM patients. Statistically significant results were obtained when different stages of PC maturation (classified based on CD19 and CD81 expression) were associated with CD117 expression and identified CNAs. In the intermediately differentiated PC group (CD19(-) CD81(+)), patients who didn't express CD117 had a lower median progression free survival (PFS) (p = 0.024). Moreover, within this group, patients with less than three adverse CNAs, which harbor CD117, had a better outcome with a PFS of more than 48 months compared with 19 months (p = 0.008). Considering all the results, our study suggested the need to integrate both the CD markers and copy number alterations to evaluate the prognosis of newly diagnosed multiple myeloma patients.

Screening for latent BK virus infection in a renal transplant population for the first time in Romania: a single-center experience.

INTRODUCTION: The BK virus nephropathy (BKVN) is one of the most important infectious complications in renal transplant recipients. As BKVN lacks any effective antiviral treatment, early diagnosis is required in order to try to limit viral replication and subsequent damage to the renal allograft, by reducing the immunosuppressive therapy. Our study, the first of its kind in Romania, aimed to assess the prevalence of BKVN among renal transplant patients in our center. MATERIALS AND METHODS: In this cross-sectional study, we included 143 renal transplant patients from our center who had received their renal allograft between 2005 and 2010. We searched for latent BK virus infection by detection of serum anti-BK virus antibodies, using an in-house developed enzyme-linked immunosorbent assay (ELISA) technique. Serology was considered positive if results were >0.33 optical density units. In patients with positive serology, we searched for BKVN with qualitative (polymerase chain reaction, PCR) and quantitative (TaqMan real-time PCR) molecular techniques. Additionally, we searched for other viral infections, including hepatitis B (with HBsAg test), hepatitis C (with anti-HCV Abs test), and cytomegalovirus (CMV, with pp65Ag test). RESULTS: All patients screened with ELISA were found to have positive BK virus serology and two of these were diagnosed with BKVN. Both patients with BKVN presented with acute impairment of the renal graft function, and one of them also developed a ureteral graft stenosis. In both cases, BKVN resolved after reduction of immunosuppressive doses. We also diagnosed hepatitis B in 18.18%, hepatitis C in 7.0%, and CMV in 27.97% of patients. CONCLUSIONS: Our study demonstrates for the first time the existence of BK virus in Romania, and we believe it opens the prospective of diagnosing BKVN in high-risk patients in our country in the future. In renal transplant patients from our center, we found the prevalence of BK virus infection to be as high as 100%. The prevalence of hepatitis B and CMV was also remarkably high. In patients with BKVN, the reduction of immunosuppression enables the spontaneous resolution of the disease.