Münci Yağcı1, Fatih Karakaya2, Elif Suyanı2, Rauf Haznedar2. 1. Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey. Electronic address: ayagci@gazi.edu.tr. 2. Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey.
Abstract
BACKGROUND: The aim of this study was to investigate the prognostic effect of serum free light chain (sFLC) response after 2 cycles of first-line chemotherapy (CT) in multiple myeloma (MM) patients. MATERIALS AND METHODS: The data of 78 newly diagnosed MM patients who had sFLC levels at diagnosis and after 2 cycles of first-line CT were included in the study. The prognostic effect of sFLCs were evaluated with normalization of sFLC κ/λ ratio after 2 cycles of CT and involved/uninvolved (i/u) sFLCs. RESULTS: At the end of follow-up the probability of overall survival (OS) was 95.7% versus 68.5% in patients with and without normalized sFLC κ/λ ratio, respectively (P = .072). The probability of OS with i/u sFLC assessment was 97.4% versus 55.8% with regard to i/u sFLC ≤ 10 and > 10, respectively (P = .001). In univariate and multivariate analysis including sFLC ratio, age, sex, and International Staging System, i/u sFLC ratio > 10 after 2 cycles of CT was identified as an independent risk factor for OS (P = .015; hazard ratio [HR], 13.2; 95% confidence interval [CI], 1.668-104.65 vs. P = .011; HR, 15.17; 95% CI, 1.85-123.89). CONCLUSION: Early response assessment in terms of sFLC after 2 courses of induction CT seems to have a prognostic effect in MM patients. The methodology and timing of the evaluation based on sFLCs needs to be validated in prospective studies.
BACKGROUND: The aim of this study was to investigate the prognostic effect of serum free light chain (sFLC) response after 2 cycles of first-line chemotherapy (CT) in multiple myeloma (MM) patients. MATERIALS AND METHODS: The data of 78 newly diagnosed MMpatients who had sFLC levels at diagnosis and after 2 cycles of first-line CT were included in the study. The prognostic effect of sFLCs were evaluated with normalization of sFLC κ/λ ratio after 2 cycles of CT and involved/uninvolved (i/u) sFLCs. RESULTS: At the end of follow-up the probability of overall survival (OS) was 95.7% versus 68.5% in patients with and without normalized sFLC κ/λ ratio, respectively (P = .072). The probability of OS with i/u sFLC assessment was 97.4% versus 55.8% with regard to i/u sFLC ≤ 10 and > 10, respectively (P = .001). In univariate and multivariate analysis including sFLC ratio, age, sex, and International Staging System, i/u sFLC ratio > 10 after 2 cycles of CT was identified as an independent risk factor for OS (P = .015; hazard ratio [HR], 13.2; 95% confidence interval [CI], 1.668-104.65 vs. P = .011; HR, 15.17; 95% CI, 1.85-123.89). CONCLUSION: Early response assessment in terms of sFLC after 2 courses of induction CT seems to have a prognostic effect in MMpatients. The methodology and timing of the evaluation based on sFLCs needs to be validated in prospective studies.
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