P-386 A High Risk of Progression from Smoldering to Symptomatic Multiple Myeloma Was Predicted by Bone Marrow and Circulating Gamma Delta T Cells

and 9 months (range 3-34) in controls.Within the memory CD4 T cell compartment there was significant enrichment of ribosomal proteins (RPs) (RPL10,12,13,18,27,29) among the LTRs compared to the controls at diagnosis and after treatment.RPs are required for effective mTOR-mediated, metabolic reprogramming of naïve to effector T cells.PPARg which is implicated in mTOR mediated metabolic reprogramming of CD4 T cells, was upregulated in the memory CD4 T cell compartment in LTRs.Conclusions: We demonstrate high expression of ribosomal proteins in the memory T cell CD4 compartment of LTRs at diagnosis and after treatment with Rd.Our study is limited by small numbers.However, our results show that the BM microenvironment in LTRs after lenalidomide therapy is characterized by a CD4 memory T cell pool with higher capacity for proliferation and differentiation.Our future goal is to compare the transcriptomic landscape of malignant cells between LTR and controls.