Circular RNA_0003489 reflects unfavorable treatment response and shortened survival in newly diagnosed multiple myeloma patients who receive bortezomib-based induction therapy.

Objectives: Circular RNA_0003489 (Circ_0003489) promotes multiple myeloma (MM) progression and bortezomib resistance in MM cells, while its potential as a biomarker in newly diagnosed MM (NDMM) patients is unclear. Thus, this study aimed to investigate the association of circ_0003489 expression with treatment response and survival in NDMM patients who received bortezomib-based induction therapy.

Methods: Bone marrow (BM) specimens from 85 NDMM patients at diagnosis or before treatment and from 15 donor controls during BM examination were retrieved in this retrospective study. Circ_0003489 derived from BM plasma cells was detected by reverse transcription-quantitative polymerase chain reaction and cut by quartile and median for further analysis.

Results: Circ_0003489 expression was increased in NDMM patients versus donor controls (< 0.001). Circ_0003489 quartile was positively correlated with BM plasma cells (= 0.040), international staging system (ISS) stage (= 0.007), the revision of ISS stage (= 0.003), beta-2-microglobulin (= 0.011), and lactate dehydrogenase (= 0.042) in NDMM patients. Increased circ_0003489 quartile was linked with a lower possibility of achieving complete response (= 0.020) and partial response or better (= 0.041) in NDMM patients. Elevated circ_0003489 expression cut by quartile (= 0.020) and cut by median (= 0.006) were linked with decreased progression-free survival (PFS) in NDMM patients. Increased circ_0003489 expression cut by median was associated with shortened overall survival (OS) in NDMM patients (= 0.038). Meanwhile, higher circ_0003489 quartile independently forecasted poorer PFS (hazard ratio = 1.342, = 0.045), but not OS in NDMM patients.

Conclusion: Circ_0003489 expression is increased and reflects unfavorable treatment response and survival in NDMM patients who receive bortezomib-based induction therapy.