Jakub Radocha1, Luděk Pour2, Tomáš Pika3, Vladimír Maisnar1, Ivan Špička4, Evžen Gregora5, Marta Krejčí2, Jiří Minařík3, Kateřina Machálková1, Jan Straub4, Petr Pavlíček5, Roman Hájek6, Pavel Žák1. 1. 4th Department of Medicine - Hematology, Charles University Hospital and Faculty of Medicine Hradec, Králové, Czech Republic. 2. Department of Internal Medicine-Hematooncology, University Hospital Brno, Brno, Czech Republic. 3. Department of Internal Medicine III, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic. 4. First Department of Medicine-Department of Hematology, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic. 5. Department of Clinical Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic. 6. Department of Clinical Hematology, University Hospital Ostrava, Ostrava, Czech Republic.
Abstract
INTRODUCTION: The normalization of free light chain ratio (FLCr) has been introduced as a marker of stringent complete remission (CR) of multiple myeloma (MM). There is currently a lack of literature assessing the role of FLCr on MM disease progression and remission status. PATIENTS AND METHODS: A multicentered retrospective review of 125 patients with MM in CR and various FLCr values was completed. Parameters of interest included patient demographics, FLCr values, complete remission (CR)/relapse status, and time to progression (TTP). The FLCr values were recorded to provide time-dependent findings on the role of FLCr on progression-free survival and overall survival (OS). RESULTS: The mean follow-up time of 125 patients from five hospitals in the Czech Republic was 31 months. A total of 47.2% of patients relapsed (54 of 125) during the follow-up period. The median TTP of patients with normal FLCr (n = 66) was 54.4 and 40.2 months for patients with abnormal FLCr (n = 59) (P = 0.217). None of the patients reached median overall survival regardless of FLCr values (P = 0.821). In the subgroup of newly diagnosed patients after upfront autologous stem cell transplantation (ASCT), there were 55.6% of patients (35 of 63) with normal FLCr and 44.4% (28 of 64) with abnormal FLCr. A total of 34.9% of patients (22 of 63) relapsed in this subgroup. Within the abnormal FLCr patients, a median TTP was 56.3 months, but no median TTP was reached among the normal FLCr patients (P = 0.746). Median OS in patients with normal (nFLCr) and abnormal FLCr (aFLCr) was not reached (P = 0.787). CONCLUSION: We did not observe any benefit from FLCr normalization in CR in myeloma patients in terms of progression-free survival or overall survival.
INTRODUCTION: The normalization of free light chain ratio (FLCr) has been introduced as a marker of stringent complete remission (CR) of multiple myeloma (MM). There is currently a lack of literature assessing the role of FLCr on MM disease progression and remission status. PATIENTS AND METHODS: A multicentered retrospective review of 125 patients with MM in CR and various FLCr values was completed. Parameters of interest included patient demographics, FLCr values, complete remission (CR)/relapse status, and time to progression (TTP). The FLCr values were recorded to provide time-dependent findings on the role of FLCr on progression-free survival and overall survival (OS). RESULTS: The mean follow-up time of 125 patients from five hospitals in the Czech Republic was 31 months. A total of 47.2% of patients relapsed (54 of 125) during the follow-up period. The median TTP of patients with normal FLCr (n = 66) was 54.4 and 40.2 months for patients with abnormal FLCr (n = 59) (P = 0.217). None of the patients reached median overall survival regardless of FLCr values (P = 0.821). In the subgroup of newly diagnosed patients after upfront autologous stem cell transplantation (ASCT), there were 55.6% of patients (35 of 63) with normal FLCr and 44.4% (28 of 64) with abnormal FLCr. A total of 34.9% of patients (22 of 63) relapsed in this subgroup. Within the abnormal FLCr patients, a median TTP was 56.3 months, but no median TTP was reached among the normal FLCr patients (P = 0.746). Median OS in patients with normal (nFLCr) and abnormal FLCr (aFLCr) was not reached (P = 0.787). CONCLUSION: We did not observe any benefit from FLCr normalization in CR in myelomapatients in terms of progression-free survival or overall survival.
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: 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
Authors: Lucia Lopez-Anglada; Cecilia Cueto-Felgueroso; Laura Rosiñol; Albert Oriol; Ana Isabel Teruel; Ana Lopez de la Guia; Enrique Bengoechea; Luis Palomera; Felipe de Arriba; Jose Mariano Hernandez; Miquel Granell; Francisco Javier Peñalver; Ramon Garcia-Sanz; Juan Besalduch; Yolanda Gonzalez; Rafael Benigno Martinez; Miguel Teodoro Hernandez; Norma C Gutierrez; Paloma Puerta; Antonio Valeri; Bruno Paiva; Joan Blade; Maria-Victoria Mateos; Jesus San Miguel; Juan Jose Lahuerta; Joaquin Martinez-Lopez Journal: PLoS One Date: 2018-09-07 Impact factor: 3.240