{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:22:03Z","timestamp":1790842923006,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Surface antigens are commonly used in flow cytometry assays for the diagnosis of multiple myeloma (MM). Some of these are directly involved in MM pathogenesis or interactions with the microenvironment, but most are used for either diagnostic or prognostic purposes. In a previous study, we showed that in-vitro, CD24-positive plasma cells exhibit a less tumorigenic phenotype. Here, we assessed the prognostic importance of CD24 expression in patients newly diagnosed with MM as it correlates to their clinical course. Immunophenotyping by flow cytometry of 124 patients uniformly treated by a bortezomib-based protocol was performed. The expression of CD24, CD117, CD19, CD45, and CD56 in bone marrow PCs was tested for correlations to clinical parameters. None of the CD markers correlated with the response rates to first-line therapy. However, patients with elevated CD24+ expression on their PCs at diagnosis had a significantly longer PFS (p = 0.002) and OS (p = 0.044). In contrast, the expression of CD117, CD56, or CD45 was found to have no prognostic value; CD19 expression was inversely correlated with PFS alone (p &lt; 0.001) and not with OS. Thus, elevated CD24 expression on PCs appears to be strongly correlated with survival and can be used as a single-surface antigenic prognostic factor in MM.<\/jats:p>","DOI":"10.3390\/jcm11102913","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T13:56:12Z","timestamp":1653054972000},"page":"2913","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["CD24 Is a Prognostic Marker for Multiple Myeloma Progression and Survival"],"prefix":"10.3390","volume":"11","author":[{"given":"Noa","family":"Gross Even-Zohar","sequence":"first","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0846-2918","authenticated-orcid":false,"given":"Marjorie","family":"Pick","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-2615","authenticated-orcid":false,"given":"Liron","family":"Hofstetter","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva 4941492, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adir","family":"Shaulov","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boaz","family":"Nachmias","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5215-7278","authenticated-orcid":false,"given":"Eyal","family":"Lebel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9426-4482","authenticated-orcid":false,"given":"Moshe E.","family":"Gatt","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/ajh.25791","article-title":"Multiple myeloma: 2020 update on diagnosis, risk-stratification and management","volume":"95","author":"Rajkumar","year":"2020","journal-title":"Am. J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1002\/hon.2586","article-title":"Multiple myeloma: Every year a new standard?","volume":"37","author":"Rajkumar","year":"2019","journal-title":"Hematol. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1172\/JCI129205","article-title":"Immunotherapy of multiple myeloma","volume":"130","author":"Minnie","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/nrclinonc.2016.122","article-title":"Genomic complexity of multiple myeloma and its clinical implications","volume":"14","author":"Manier","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Giannakoulas, N., Ntanasis-Stathopoulos, I., and Terpos, E. (2021). The Role of Marrow Microenvironment in the Growth and Development of Malignant Plasma Cells in Multiple Myeloma. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22094462"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.1182\/blood.V89.9.3385","article-title":"CD24, a Mucin-Type Glycoprotein, Is a Ligand for P-Selectin on Human Tumor Cells","volume":"89","author":"Aigner","year":"1997","journal-title":"Blood"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2174\/1566523220666200623170738","article-title":"CD24, A Review of its Role in Tumor Diagnosis, Progression and Therapy","volume":"20","author":"Zhao","year":"2020","journal-title":"Curr. Gene Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4858","DOI":"10.1158\/0008-5472.CAN-17-0367","article-title":"Nuclear CD24 Drives Tumor Growth and Is Predictive of Poor Patient Prognosis","volume":"77","author":"Duex","year":"2017","journal-title":"Cancer Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"5480","DOI":"10.18632\/oncotarget.27190","article-title":"The role of CD24 in multiple myeloma tumorigenicity and effects of the microenvironment on its expression","volume":"10","author":"Gilad","year":"2019","journal-title":"Oncotarget"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"98931","DOI":"10.18632\/oncotarget.22131","article-title":"CD24, CD27, CD36 and CD302 gene expression for outcome prediction in patients with multiple myeloma","volume":"8","author":"Alaterre","year":"2017","journal-title":"Oncotarget"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e617","DOI":"10.1038\/bcj.2017.90","article-title":"Current applications of multiparameter flow cytometry in plasma cell disorders","volume":"7","author":"Bezdekova","year":"2017","journal-title":"Blood Cancer J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.leukres.2016.03.003","article-title":"The prognostic significance of CD45 expression by clonal bone marrow plasma cells in patients with newly diagnosed multiple myeloma","volume":"44","author":"Gonsalves","year":"2016","journal-title":"Leuk. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1080\/07357907.2021.1964521","article-title":"Prognostic Relevance of Concordant Expression CD69 and CD56 in Response to Bortezomib Combination Therapy in Multiple Myeloma Patients","volume":"39","author":"ElMenshawy","year":"2021","journal-title":"Cancer Investig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"153567","DOI":"10.1016\/j.prp.2021.153567","article-title":"CD56 expression in multiple myeloma: Correlation with poor prognostic markers but no effect on outcome","volume":"225","author":"Koumpis","year":"2021","journal-title":"Pathol.-Res. Pract."},{"key":"ref_17","first-page":"328","article-title":"CD117 expression in gammopathies is associated with an altered maturation of the myeloid and lymphoid hematopoietic cell compartments and favorable disease features","volume":"96","author":"Paiva","year":"2010","journal-title":"Haematologica"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1038\/leu.2012.42","article-title":"Clinical significance of CD81 expression by clonal plasma cells in high-risk smoldering and symptomatic multiple myeloma patients","volume":"26","author":"Paiva","year":"2012","journal-title":"Leukemia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e0196780","DOI":"10.1371\/journal.pone.0196780","article-title":"Low expression of neural cell adhesion molecule, CD56, is associated with low efficacy of bortezomib plus dexamethasone therapy in multiple myeloma","volume":"13","author":"Yoshida","year":"2018","journal-title":"PLoS ONE"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2863","DOI":"10.1200\/JCO.2015.61.2267","article-title":"Revised International Staging System for Multiple Myeloma: A Report from International Myeloma Working Group","volume":"33","author":"Palumbo","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma","volume":"17","author":"Kumar","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1038\/leu.2012.100","article-title":"Consensus guidelines for the conduct and reporting of clinical trials in systemic light-chain amyloidosis","volume":"26","author":"Comenzo","year":"2012","journal-title":"Leukemia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4369","DOI":"10.1182\/blood-2009-05-221689","article-title":"The persistence of immunophenotypically normal residual bone marrow plasma cells at diagnosis identifies a good prognostic subgroup of symptomatic multiple myeloma patients","volume":"114","author":"Paiva","year":"2009","journal-title":"Blood"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.3324\/haematol.2018.189159","article-title":"European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: What to use and when","volume":"103","author":"Caers","year":"2018","journal-title":"Haematologica"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"431","DOI":"10.3324\/haematol.11080","article-title":"Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders","volume":"93","author":"Rawstron","year":"2008","journal-title":"Haematologica"},{"key":"ref_26","first-page":"61","article-title":"Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma","volume":"90","author":"Paiva","year":"2015","journal-title":"Cytom. Part B Clin. Cytom."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.3324\/haematol.2009.009100","article-title":"Multiparameter flow cytometry quantification of bone marrow plasma cells at diagnosis provides more prognostic information than morphological assessment in myeloma patients","volume":"94","author":"Paiva","year":"2009","journal-title":"Haematologica"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/cyto.b.20512","article-title":"Utility of flow cytometry immunophenotyping in multiple myeloma and other clonal plasma cell-related disorders","volume":"78","author":"Paiva","year":"2010","journal-title":"Cytom. Part B Clin. Cytom."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2737","DOI":"10.1200\/JCO.2007.15.4120","article-title":"Prognostic Value of Immunophenotyping in Multiple Myeloma: A Study by the PETHEMA\/GEM Cooperative Study Groups on Patients Uniformly Treated with High-Dose Therapy","volume":"26","author":"Mateo","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1136\/jcp.2009.065128","article-title":"The significance of tumour cell immunophenotype in myeloma and its impact on clinical outcome","volume":"62","author":"Ngo","year":"2009","journal-title":"J. Clin. Pathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3770","DOI":"10.1182\/blood-2013-10-530964","article-title":"CD28-mediated pro-survival signaling induces chemotherapeutic resistance in multiple myeloma","volume":"123","author":"Murray","year":"2014","journal-title":"Blood"},{"key":"ref_32","first-page":"1234","article-title":"The Phenotype of Normal, Reactive and Malignant Plasma Cells. Identification of \u201cMany and Multiple Myelomas\u201d and of New Targets for Myeloma Therapy","volume":"91","author":"Bataille","year":"2006","journal-title":"Haematologica"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/sj.bjc.6600702","article-title":"CD24 is an independent prognostic marker of survival in nonsmall cell lung cancer patients","volume":"88","author":"Kristiansen","year":"2003","journal-title":"Br. J. Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ria, R., and Vacca, A. (2020). Bone Marrow Stromal Cells-Induced Drug Resistance in Multiple Myeloma. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21020613"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1159\/000520312","article-title":"Multiple Myeloma: Molecular Pathogenesis and Disease Evolution","volume":"44","author":"Heider","year":"2021","journal-title":"Oncol. Res. Treat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"593","DOI":"10.3324\/haematol.2016.145078","article-title":"Evaluation of the Revised International Staging System in an independent cohort of unselected patients with multiple myeloma","volume":"102","author":"Kastritis","year":"2016","journal-title":"Haematologica"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1007\/s12288-019-01240-4","article-title":"Risk Stratification in Multiple Myeloma in Indian Settings","volume":"36","author":"Kapoor","year":"2019","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1080\/17474086.2018.1537776","article-title":"Prognostic factors for multiple myeloma in the era of novel therapies","volume":"11","author":"Ziogas","year":"2018","journal-title":"Expert Rev. Hematol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1038\/s41467-019-09555-6","article-title":"Multiple myeloma immunoglobulin lambda translocations portend poor prognosis","volume":"10","author":"Barwick","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1093\/jnci\/djz159","article-title":"Identification and Characterization of Tumor-Initiating Cells in Multiple Myeloma","volume":"112","author":"Gao","year":"2019","journal-title":"JNCI J. Natl. Cancer Inst."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35466","DOI":"10.18632\/oncotarget.8154","article-title":"Multiple myeloma cancer stem cells","volume":"7","author":"Gao","year":"2016","journal-title":"Oncotarget"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Ortiz, A., Rodr\u00edguez-Garc\u00eda, Y., Encinas, J., Maroto-Mart\u00edn, E., Castellano, E., Teixid\u00f3, J., and Mart\u00ednez-L\u00f3pez, J. (2021). The Role of Tumor Microenvironment in Multiple Myeloma Development and Progression. Cancers, 13.","DOI":"10.3390\/cancers13020217"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1002\/ijc.33249","article-title":"Novel insights into the function of CD24: A driving force in cancer","volume":"148","author":"Altevogt","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3802","DOI":"10.1158\/0008-5472.CAN-11-0519","article-title":"CD24 Offers a Therapeutic Target for Control of Bladder Cancer Metastasis Based on a Requirement for Lung Colonization","volume":"71","author":"Overdevest","year":"2011","journal-title":"Cancer Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2913\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:15:57Z","timestamp":1760138157000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/10\/2913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,20]]},"references-count":44,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jcm11102913"],"URL":"https:\/\/doi.org\/10.3390\/jcm11102913","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,20]]}}}