Prediction of early relapse in multiple myeloma patients after Autologous hematopoietic stem cell transplantation by miR-21 and miR-181a.

Background: MicroRNAs (miRs) are small non-coding RNAs that have been extensively reported to be involved in multiple myeloma (MM) pathogenesis and progression. While the precise role of miRs in MM remains to be fully elucidated, they have demonstrated significant potential as prognostic markers in various other cancers. This study aimed to investigate the relationship between miR-21, miR-181a, and miR-23b expression before autologous hematopoietic stem cell transplantation (AHSCT) and post-transplant early relapse (ER) incidence in MM patients.

Methods and results: Thirty-five diagnosed MM patients who were eligible for AHSCT were included. The relative expression of the miRs was determined in peripheral blood samples collected at the time of apheresis using a quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Patients were stratified into two groups based on whether their miR expressions were above or below the median. Eight of thirty-five patients (22.8%) experienced ER within 12 months (with a median of 8.1 months) after AHSCT. Patients with miR-21 expression levels below 2.1 showed delayed relapse, with no early relapse observed within the first ten months. In contrast, high expression of miR-181a (≥ 3.5) was associated with a relapse rate exceeding 75% by approximately five months.

Conclusion: This study highlights the potential of miR-21 and miR-181a as biomarkers for predicting ER in MM patients undergoing AHSCT. Ultimately, these findings facilitate the development of targeted interventions and personalized risk assessments, improving patient outcomes. Further research is needed to validate and expand these promising results, optimizing the use of miR-based tools in clinical practice.