Work

RVd and CyBorD therapies remodel B-cell maturation signaling and alter immune and clonal architecture in multiple myeloma

Year: 2025
Type: article
Abstract: BACKGROUND: Multiple myeloma (MM) features plasma cell (PC) heterogeneity and alterations in B-cell differentiation and immune regulation. Although lenalidomide/bortezomib/dexamethasone (RVd) and cyclophosphamide/bortezomib/dexamethasone (CyBorD) are clinically effective, their precise impacts on PC/B-cell maturation remain unclear. METHODS: = 10). RESULTS: RVd and CyBorD therapies exerted distinct immune modulation patterns, differentially affecting PC, early B-cell stages, and naive T cells. Evaluation of transcriptional B-cell regulators in B-cell lymphopoiesis revealed that both regimens decreased IRF4, CXCR4, and FGFR3 while upregulating Pax-5 across B-cell stages and PC. RVd uniquely upregulated MYD88 and c-Myc and decreased sXBP1; its responders further suppressed BLIMP-1 and FGFR3. In contrast, CyBorD elevated sXBP1, BLIMP-1, and Notch-1 while reducing c-Myc in the B and PC subsets. Both therapies increased the expression of the stemness factor KLF4 and variably modulated NANOG; CyBorD altered Nestin and RARα2 in responder PCs, whereas RVd suppressed OCT3/4. Shared immunophenotypic aberrations included decreased MMSET, CD200, and CD52, and increased CD47, CD81, and CD44 in B-cell compartments. In PC, both regimens elevated CD338 while reducing CD47, CD319, and CD138. RVd responders further downregulated CD56, CD269, and CD329, and increased CD243. CONCLUSIONS: These shared and divergent modulations elucidate the molecular underpinnings of RVd and CyBorD efficacy and inform precision regimen selection.
Language: English
Subfield: Hematology
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,970
OpenAlex ID: W4417462673
FWCI: 1.915
Cites: 54
Cited by: 3
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