Baseline lncRNA PCAT1 high expression and its longitude increment during induction therapy predict worse prognosis in multiple myeloma patients

Background: Long noncoding RNA PCAT1 (lnc-PCAT1) involves in the proliferation and drug sensitivity of multiple myeloma (MM), while its prognostic role in MM patients is still obscure. This study aimed to explore the association of lnc-PCAT1 with MM risk, clinical characteristics, treatment response, progression-free survival (PFS), and overall survival (OS).

Methods: A total of 83 symptomatic MM patients were enrolled in this study. Additionally, 30 healthy bone marrow donors as health controls were also recruited. Bone marrow plasma cell samples of MM patients and health donors were collected. Lnc-PCAT1 in bone marrow plasma cells was detected by reverse transcription-quantitative polymerase chain reaction.

Results: Lnc-PCAT1 was increased in MM patients than in health donors (p < 0.001), and receiver operating characteristic (ROC) curve showed that lnc-PCAT1 had excellent capability of discriminating MM patients from health donors (area under curve: 0.932, 95% confidence interval: 0.889-0.976). In MM patients, lnc-PCAT1 was correlated with bone lesion (p = 0.024), higher β₂ -MG (p = 0.005), LDH (p = 0.037), and presence of Del (17p) (p = 0.029). Lnc-PCAT1 was also associated with poor ISS stage (p = 0.013) and R-ISS stage (p = 0.005). Besides, lnc-PCAT1 was reduced after treatment (p < 0.001); meanwhile, lnc-PCAT1 before treatment was correlated with lower CR (p = 0.046) but not ORR (p = 0.185). Additionally, lnc-PCAT1 after treatment was associated with lower CR (p = 0.003) and ORR (p = 0.010). Furthermore, baseline Inc-PCAT1 high and Inc-PCAT1 increase after treatment were correlated with worse PFS and OS (all p < 0.05).

Conclusion: Lnc-PCAT1 dysregulation serves as a biomarker for diagnosis and prognosis for MM.