Role of serum-free light chain assay for defining response and progression in immunoglobulin secretory multiple myeloma.
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
13
09
2022
received:
24
06
2022
accepted:
15
09
2022
pubmed:
6
10
2022
medline:
11
11
2022
entrez:
5
10
2022
Statut:
ppublish
Résumé
The International Myeloma Working Group (IMWG) guidelines recommend using electrophoresis and immunofixation to define response and progressive disease (PD) in immunoglobulin (Ig) secretory multiple myeloma (Ig-MM), whereas the role of serum-free light chain (sFLC) is controversial. We retrospectively analyzed the value of adding sFLC assays in the definition of response and PD according to IMWG criteria in 339 Ig-MM patients treated with a first-line novel agent-based therapy (median follow-up 54 months). sFLC PD was defined according to conventional criteria plus increased sFLC levels, or sFLC escape (sFLCe); progression/sFLCe-free survival (ePFS) was the time from the start of treatment to the date of first PD or sFLCe, or death; overall survival after PD/sFLCe (OS after Pe) was the time from first PD or sFLCe to the date of death. 148 (44%) patients achieved a complete response and 198 (60%) a normal sFLC ratio (sFLCR). sFLCR normalization was an independent prognostic factor for extended PFS (HR = 0.46, p = 0.001) and OS (HR = 0.47, p = 0.006) by multivariable analysis. 175 (52%) patients experienced PD according to the IMWG criteria, whereas 180 (53%) experienced PD or sFLCe. Overall, a sFLCe was observed in 31 (9%) patients. Median PFS and ePFS were both equal to 36 (95% CI = 32-42, and 32-40, respectively) months. sFLC PD adversely affected the OS after Pe compared to PD with increasing monoclonal Ig only (HR = 0.52, p = 0.012). Our results support the inclusion of the sFLC assay for defining response and PD in Ig-MM.
Identifiants
pubmed: 36198076
doi: 10.1002/ajh.26747
pmc: PMC9828555
doi:
Substances chimiques
Immunoglobulin Light Chains
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1607-1615Informations de copyright
© 2022 The Authors. American Journal of Hematology published by Wiley Periodicals LLC.
Références
Lancet Oncol. 2014 Nov;15(12):e538-48
pubmed: 25439696
Leukemia. 2008 Oct;22(10):1933-7
pubmed: 18596742
Blood. 2008 May 15;111(10):4908-15
pubmed: 18364469
Blood. 2014 May 29;123(22):3414-9
pubmed: 24733348
Leuk Lymphoma. 2013 Jan;54(1):123-32
pubmed: 22712834
Blood. 2015 Aug 13;126(7):858-62
pubmed: 26089396
Br J Haematol. 2004 Aug;126(3):348-54
pubmed: 15257706
Haematologica. 2017 Mar;102(3):e104-e107
pubmed: 27909220
Clin Lymphoma Myeloma Leuk. 2010 Feb;10(1):E10-3
pubmed: 20223721
Clin Chem. 2001 Apr;47(4):673-80
pubmed: 11274017
Clin Chem. 2009 Aug;55(8):1517-22
pubmed: 19520758
Blood Cancer J. 2021 Feb 1;11(2):24
pubmed: 33563895
J Clin Oncol. 2005 May 20;23(15):3412-20
pubmed: 15809451
Lancet. 2003 Feb 8;361(9356):489-91
pubmed: 12583950
Blood. 2007 Aug 1;110(3):827-32
pubmed: 17416735
Hematol Oncol. 2013 Jun;31(2):96-102
pubmed: 22961993
Am J Hematol. 2022 Dec;97(12):1607-1615
pubmed: 36198076
Leuk Lymphoma. 2016 Sep;57(9):2058-64
pubmed: 26763357
Blood. 2001 May 1;97(9):2900-2
pubmed: 11313287
Leukemia. 2019 Feb;33(2):313-318
pubmed: 30573778
Leukemia. 2015 Oct;29(10):2033-8
pubmed: 25962523
PLoS One. 2020 Aug 31;15(8):e0237155
pubmed: 32866200
Leukemia. 2006 Sep;20(9):1467-73
pubmed: 16855634
Clin Chem. 2002 Sep;48(9):1437-44
pubmed: 12194920
Blood. 2011 May 5;117(18):4691-5
pubmed: 21292775
Br J Haematol. 2007 May;137(3):240-3
pubmed: 17408464
Blood Adv. 2020 Jan 28;4(2):322-326
pubmed: 31978213
Blood. 2016 Jun 16;127(24):2955-62
pubmed: 27002115
J Clin Oncol. 2013 Dec 20;31(36):4529-35
pubmed: 24248686
Haematologica. 2007 Aug;92(8):1135-8
pubmed: 17650446
Blood Cancer J. 2020 Oct 16;10(10):102
pubmed: 33067414
Haematologica. 2016 Mar;101(3):356-62
pubmed: 26635032
Blood Adv. 2022 Jun 14;6(11):3234-3239
pubmed: 35157768
Lancet Oncol. 2016 Aug;17(8):e328-e346
pubmed: 27511158
Cancers (Basel). 2021 Sep 28;13(19):
pubmed: 34638344
Ann Hematol. 2020 Aug;99(8):1779-1791
pubmed: 32594218
PLoS One. 2018 Sep 7;13(9):e0203392
pubmed: 30192814