BACKGROUND: Observational data from clinical studies indicate that the goal of first-line therapy in newly diagnosed patients with symptomatic multiple myeloma (MM) should be very good partial response (VGPR) or better, preferably before high-dose treatment. We evaluated the value of early measurements of involved free light chains (iFLC) in prediction of high-quality responses. Measuring iFLC has a potential advantage due to a short half-life compared to the half-life of the M-protein. METHODS: In 36 multiple myeloma (MM) patients, we measured serial changes in iFLC and M-protein after start of treatment. iFLC and M-protein were measured before treatment, the following 5 wk days, 2, 3 and 6 wks after start of treatment. RESULTS: Median iFLC and M-protein half-life was 2.75 and 11.9 d, respectively. All patients with an iFLC >75 mg/L had an initial significant reduction (>20%) in iFLC, even patients with no response to treatment. The mean per cent reduction in iFLC 3 d after start of treatment was 52.3% and 23.6% (P = 0.021) in patients achieving ≥VGPR and PR, respectively. The mean per cent reduction in M-protein in patients achieving ≥VGPR and PR was not significantly different in the 6-wk study period. As a predictor of VGPR, an 80% reduction in iFLC at day 21 resulted in a sensitivity of 87.5% and a specificity of 100%. CONCLUSION: Changes in iFLC could be a tool for early identification of responders to anti-myeloma therapy. Early, sequential measurements of iFLC within the first week after start of treatment are not meaningful.
BACKGROUND: Observational data from clinical studies indicate that the goal of first-line therapy in newly diagnosed patients with symptomatic multiple myeloma (MM) should be very good partial response (VGPR) or better, preferably before high-dose treatment. We evaluated the value of early measurements of involved free light chains (iFLC) in prediction of high-quality responses. Measuring iFLC has a potential advantage due to a short half-life compared to the half-life of the M-protein. METHODS: In 36 multiple myeloma (MM) patients, we measured serial changes in iFLC and M-protein after start of treatment. iFLC and M-protein were measured before treatment, the following 5 wk days, 2, 3 and 6 wks after start of treatment. RESULTS: Median iFLC and M-protein half-life was 2.75 and 11.9 d, respectively. All patients with an iFLC >75 mg/L had an initial significant reduction (>20%) in iFLC, even patients with no response to treatment. The mean per cent reduction in iFLC 3 d after start of treatment was 52.3% and 23.6% (P = 0.021) in patients achieving ≥VGPR and PR, respectively. The mean per cent reduction in M-protein in patients achieving ≥VGPR and PR was not significantly different in the 6-wk study period. As a predictor of VGPR, an 80% reduction in iFLC at day 21 resulted in a sensitivity of 87.5% and a specificity of 100%. CONCLUSION: Changes in iFLC could be a tool for early identification of responders to anti-myeloma therapy. Early, sequential measurements of iFLC within the first week after start of treatment are not meaningful.
Authors: Tanja Holzhey; Wolfram Pönisch; Song-Yau Wang; Madlen Holzvogt; Bruno Holzvogt; Marc Andrea; Thomas Zehrfeld; Doreen Hammerschmidt; Franz Albert Hoffmann; Cornelia Becker; Andreas Schwarzer; Maik Schwarz; Uta Schönfelder-Fricke; Thomas Edelmann; Leanthe Braunert; Georg-Nikolaus Franke; Madlen Jentzsch; Sebastian Schwind; Markus Bill; Juliane Grimm; Yvonne Remane; Uwe Platzbecker; Markus Scholz Journal: J Cancer Res Clin Oncol Date: 2021-01-12 Impact factor: 4.553
Authors: Jean-Sébastien Claveau; Sophie Savary Bélanger; Imran Ahmad; Jean-Sébastien Delisle; Vincent De Guire; Jean Roy; Richard LeBlanc Journal: Blood Cancer J Date: 2022-01-05 Impact factor: 11.037
Authors: Katharina Lückerath; Constantin Lapa; Christa Albert; Ken Herrmann; Gerhard Jörg; Samuel Samnick; Herrmann Einsele; Stefan Knop; Andreas K Buck Journal: Oncotarget Date: 2015-04-10