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Background <p>The bone marrow microenvironment in multiple myeloma (MM) is characterized by complex immune dysregulation involving multiple inhibitory pathways. Among these, the programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) axis contributes to T-cell dysfunction; However, its isolated role within this multifactorial network remains incompletely defined.</p> Methods <p>This prospective observational study performed a cross-sectional immunophenotypic analysis of 39 newly diagnosed MM (NDMM) patients. PD-1 expression on T cells and PD-L1 expression on bone marrow (BM) plasma cells (PCs) were assessed using flow cytometry. Associations with clinical and laboratory parameters were analyzed using correlation analysis.</p> Results <p>PD-L1 mean fluorescence intensity (MFI) on PCs showed a positive correlation with BM T-cell percentage (<i>r</i> = 0.350, <i>p</i> = 0.029). PD-1 MFI on T cells correlated with total leukocytic count (TLC) (<i>r</i> = 0.326, <i>p</i> = 0.043). In International Staging System (ISS) stage III patients, PD-L1 expression on PC correlated with T cells% (<i>r</i> = 0.501, <i>p</i> = 0.018) and TLC (<i>r</i> = 0.427, <i>p</i> = 0.047), while PD-1 expression showed a strong positive correlation with TLC (<i>r</i> = 0.676, <i>p</i> = 0.001) and a negative correlation with age (<i>r</i> = − 0.492, <i>p</i> = 0.020). No significant association was observed with treatment response.</p> Conclusion <p>These findings provide an exploratory description of PD-1/PD-L1 expression patterns within the BM microenvironment in MM. Only in advanced cases according to ISS, PD-L1 expression on PC was linked to BM T cells frequency. PD-1/PD-L1 expression patterns were not linked to treatment response.</p>

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Programmed cell death protein 1 (PD-1) / programmed cell death ligand 1 (PD-L1) in multiple myeloma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月17日

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  • Shimaa El-Garf,
  • Reham Hammad,
  • Eman Kandeel,
  • Ahmed Rabea,
  • Mona Alrayes

摘要

Background

The bone marrow microenvironment in multiple myeloma (MM) is characterized by complex immune dysregulation involving multiple inhibitory pathways. Among these, the programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) axis contributes to T-cell dysfunction; However, its isolated role within this multifactorial network remains incompletely defined.

Methods

This prospective observational study performed a cross-sectional immunophenotypic analysis of 39 newly diagnosed MM (NDMM) patients. PD-1 expression on T cells and PD-L1 expression on bone marrow (BM) plasma cells (PCs) were assessed using flow cytometry. Associations with clinical and laboratory parameters were analyzed using correlation analysis.

Results

PD-L1 mean fluorescence intensity (MFI) on PCs showed a positive correlation with BM T-cell percentage (r = 0.350, p = 0.029). PD-1 MFI on T cells correlated with total leukocytic count (TLC) (r = 0.326, p = 0.043). In International Staging System (ISS) stage III patients, PD-L1 expression on PC correlated with T cells% (r = 0.501, p = 0.018) and TLC (r = 0.427, p = 0.047), while PD-1 expression showed a strong positive correlation with TLC (r = 0.676, p = 0.001) and a negative correlation with age (r = − 0.492, p = 0.020). No significant association was observed with treatment response.

Conclusion

These findings provide an exploratory description of PD-1/PD-L1 expression patterns within the BM microenvironment in MM. Only in advanced cases according to ISS, PD-L1 expression on PC was linked to BM T cells frequency. PD-1/PD-L1 expression patterns were not linked to treatment response.