PURPOSE: To clarify the impact of serum free light chain (sFLC) ratio normalization in patients with multiple myeloma (MM) treated with novel agents. PATIENTS AND METHODS: Treatment response in 126 consecutive patients over 7 years was assessed by IMWG criteria and sFLC assay. RESULTS: Thirty-four patients (27%) showed complete response (CR), 37 (29%) very good partial response (VGPR), 39 (31%) partial response (PR), and 16 (13%) stable disease (SD) or less at a median follow-up of 28 months. Fifty-two patients (41%) with sFLC ratio normalization showed superior progression-free survival (PFS) and overall survival (OS) compared to those who did not (3-yr OS, 94% vs. 48%; P < 0.001). This favorable effect of sFLC ratio normalization occurred irrespective of high (>1000 mg/dL) or low (<100 mg/dL) baseline sFLC. Rates of normal sFLC ratio were as follows: CR, 69%; VGPR, 64%; PR, 16%; and SD or less, 0%. OS was significantly superior in patients with than without normal sFCL ratio in respective response groups. Although various factors (advanced age >70, high LDH, ISS stage 3) showed negative prognostic impacts on PFS and OS on univariate analysis, normal sFLC ratio and achievement of CR emerged as the strongest prognostic predictors for longer OS in MM patients on multivariate analysis. CONCLUSIONS: This study demonstrated the significance of obtaining normal sFLC ratio independent of other clinical variables. Analysis of sFLC ratio could identify the favorable group of patients as well as immunofixation test and support the inclusion of sFLC ratio as part of the response criteria for MM.
PURPOSE: To clarify the impact of serum free light chain (sFLC) ratio normalization in patients with multiple myeloma (MM) treated with novel agents. PATIENTS AND METHODS: Treatment response in 126 consecutive patients over 7 years was assessed by IMWG criteria and sFLC assay. RESULTS: Thirty-four patients (27%) showed complete response (CR), 37 (29%) very good partial response (VGPR), 39 (31%) partial response (PR), and 16 (13%) stable disease (SD) or less at a median follow-up of 28 months. Fifty-two patients (41%) with sFLC ratio normalization showed superior progression-free survival (PFS) and overall survival (OS) compared to those who did not (3-yr OS, 94% vs. 48%; P < 0.001). This favorable effect of sFLC ratio normalization occurred irrespective of high (>1000 mg/dL) or low (<100 mg/dL) baseline sFLC. Rates of normal sFLC ratio were as follows: CR, 69%; VGPR, 64%; PR, 16%; and SD or less, 0%. OS was significantly superior in patients with than without normal sFCL ratio in respective response groups. Although various factors (advanced age >70, high LDH, ISS stage 3) showed negative prognostic impacts on PFS and OS on univariate analysis, normal sFLC ratio and achievement of CR emerged as the strongest prognostic predictors for longer OS in MMpatients on multivariate analysis. CONCLUSIONS: This study demonstrated the significance of obtaining normal sFLC ratio independent of other clinical variables. Analysis of sFLC ratio could identify the favorable group of patients as well as immunofixation test and support the inclusion of sFLC ratio as part of the response criteria for MM.
Authors: Nadine Abdallah; Prashant Kapoor; David L Murray; Francis K Buadi; David Dingli; Angela Dispenzieri; Morie A Gertz; Ronald S Go; Wilson I Gonsalves; Suzanne R Hayman; Taxiarchis V Kourelis; Martha Q Lacy; Nelson Leung; John A Lust; Eli Muchtar; Rahma Warsame; Robert A Kyle; S Vincent Rajkumar; Shaji K Kumar Journal: Blood Adv Date: 2020-01-28
Authors: M Alhaj Moustafa; S V Rajkumar; A Dispenzieri; M A Gertz; M Q Lacy; F K Buadi; Y L Hwa; D Dingli; P Kapoor; S R Hayman; J A Lust; R A Kyle; S K Kumar Journal: Leukemia Date: 2015-05-12 Impact factor: 11.528
Authors: Heleen D de Koning; Joost Schalkwijk; Monique Stoffels; Johanna Jongekrijg; Joannes F M Jacobs; Eugène Verwiel; Hans J P M Koenen; Frank Preijers; Dirk Holzinger; Irma Joosten; Jos W M van der Meer; Anna Simon Journal: Arthritis Res Ther Date: 2015-07-22 Impact factor: 5.156
Authors: Katharina Lückerath; Constantin Lapa; Annika Spahmann; Gerhard Jörg; Samuel Samnick; Andreas Rosenwald; Herrmann Einsele; Stefan Knop; Andreas K Buck Journal: PLoS One Date: 2013-12-23 Impact factor: 3.240
Authors: José Luis García de Veas Silva; Carmen Bermudo Guitarte; Paloma Menéndez Valladares; Johanna Carolina Rojas Noboa; Krysta Kestler; Rafael Duro Millán Journal: PLoS One Date: 2016-11-28 Impact factor: 3.240