Recovery of polyclonal immunoglobulins one year after autologous stem cell transplantation as a long-term predictor marker of progression and survival in multiple myeloma.
Verónica González-Calle,Seila Cerda,Jorge Labrador,Eduardo Sobejano,Beatriz González-Mena,Carmen Aguilera,Enrique M. Ocio,María Belén Vidriales,Noemi Puig,Norma C. Gutiérrez,Ramón García-Sanz,José María Quiroga Alonso,R. López,Carlos Aguilar,Alfonso García de Coca,R. Hernández,Jose Mariano Hernandez,Fernando Escalante,Maria-Victoria Mateos +18 more
TLDR
The recovery of polyclonal immunoglobulins one year after autologous transplantation in myeloma patients is an independent long-term predictor marker for progression and survival.Abstract:
Immunoparesis or suppression of polyclonal immunoglobulins is a very common condition in newly diagnosed myeloma patients. However, the recovery of polyclonal immunoglobulins in the setting of immune reconstitution after autologous stem cell transplantation and its effect on outcome has not yet been explored. We conducted this study in a cohort of 295 patients who had undergone autologous transplantation. In order to explore the potential role of immunoglubulin recovery as a dynamic predictor of progression or survival after transplantation, conditional probabilities of progression-free survival and overall survival were estimated according to immunoglobulin recovery at different time points using a landmark approach. One year after transplant, when B-cell reconstitution is expected to be completed, among 169 patients alive and progression free, 88 patients (52%) showed immunoglobulin recovery and 81 (48%) did not. Interestingly, the group with immunoglobulin recovery had a significantly longer median progression-free survival than the group with persistent immunoparesis (median 60.4 vs. 27.9 months, respectively; Hazard Ratio: 0.45, 95%Confidence Interval: 0.31-0.66; P<0.001), and improved overall survival (11.3 vs. 7.3 years; Hazard Ratio: 0.45, 95%Confidence Interval: 0.27-0.74; P=0.002). Furthermore, the percentage of normal plasma cells detected by flow cytometry in the bone marrow assessed at day 100 after transplantation was associated with the immunoglobulin recovery at that time and may predict immunoglobulin recovery in the subsequent months: nine months and one year. In conclusion, the recovery of polyclonal immunoglobulins one year after autologous transplantation in myeloma patients is an independent long-term predictor marker for progression and survival.read more
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Journal ArticleDOI
Characterisation of immunoparesis in newly diagnosed myeloma and its impact on progression-free and overall survival in both old and recent myeloma trials
Jennifer L J Heaney,John Campbell,John Campbell,Gulnaz Iqbal,David A Cairns,Alex G. Richter,J. Anthony Child,Walter M Gregory,Graham Jackson,Martin Kaiser,Roger G. Owen,Faith E. Davies,Gareth J. Morgan,Janet A. Dunn,Mark T. Drayson +14 more
TL;DR: It is hypothesized that IgM immunoparesis impacts through a combination of being associated with more aggressive disease and reduced immune surveillance against relapse and Infection does not appear to be the main mechanism through which Immunosuppression affects survival.
Journal ArticleDOI
Heavy+light chain monitoring correlates with clinical outcome in multiple myeloma patients
Mauricette Michallet,C Chapuis-Cellier,Thomas Dejoie,C Lombard,Hélène Caillon,Mohamad Sobh,Philippe Moreau,M. Attal,Hervé Avet-Loiseau +8 more
TL;DR: It is concluded that HLC monitoring could augment electrophoretic assessments in patients achieving VGPR, and the prognostic significance of HLC responses might partly depend on the patients’ ability to recover their immune system, as determined by normalisation of H LC measurements.
Journal ArticleDOI
High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome.
Lalit Kumar,Dev Ramavath,Babita Kataria,Akash Tiwari,Abhishek Raj,Santosh Kumar Chellapuram,Anjali Mookerjee,Ranjit Kumar Sahoo,Prabhat Singh Malik,Atul Sharma,Ritu Gupta,Om Dutt Sharma,Ahitagni Biswas,Rajesh Kumar,Sanjay Thulkar +14 more
TL;DR: Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.
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Minimal residual disease testing after stem cell transplantation for multiple myeloma.
TL;DR: Improved methods for detecting and monitoring minimal or measurable residual disease (MRD) in the post-transplant setting will refine the current definitions of remission and could guide treatment approaches.
Journal ArticleDOI
Immunoparesis defined by heavy+light chain suppression is a novel marker of long-term outcomes in cardiac AL amyloidosis.
Sajitha Sachchithanantham,Oscar Berlanga,Azra Alvi,Shameem Mahmood,Helen J. Lachmann,Julian D. Gillmore,Philip N. Hawkins,Stephen Harding,Ashutosh D. Wechalekar +8 more
TL;DR: Severe HLC immunoparesis is an independent marker of long‐term poor prognosis in AL patients with cardiac involvement and is assessed as a prognostic marker for survival in AL amyloidosis.
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Antonio Palumbo,Federica Cavallo,Francesco Di Raimondo,Dina Ben Yehuda,Maria Teresa Petrucci,Sara Pezzatti,Tommaso Caravita,Chiara Cerrato,Elena Ribakovsky,Mariella Genuardi,Anna Maria Cafro,Magda Marcatti,Lucio Catalano,Massimo Offidani,Angelo Michele Carella,Elena Zamagni,Francesca Patriarca,Pellegrino Musto,Andrea Evangelista,Giovannino Ciccone,Paola Omedè,Claudia Crippa,Paolo Corradini,Arnon Nagler,Mario Boccadoro,Michele Cavo +25 more
TL;DR: Consolidation therapy with high-dose melphalan plus stem-cell transplantation, as compared with MPR, significantly prolonged progression-free and overall survival among patients with multiple myeloma who were 65 years of age or younger.
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TL;DR: Based on in vitro data, it appears that anti-proliferative effects and downregulation of crucial cytokines are their most important anti-MM attributes.
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