Impact of detectable monoclonal protein at diagnosis on outcomes in marginal zone lymphoma: a multicenter cohort study.

Autor:	Epperla N; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH., Zhao Q; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH., Karmali R; Department of Medicine, Northwestern University, Chicago, IL., Torka P; Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY.; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY., Shea L; Department of Medicine, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO., Oh TS; Department of Medicine, Northwestern University, Chicago, IL., Anampa-Guzmán A; Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY., Reves H; Department of Medicine, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX., Tavakkoli M; Department of Medicine, University of Pennsylvania, Philadelphia, PA., Greenwell IB; Department of Medicine, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC., Hansinger E; Department of Medicine, Thomas Jefferson University, Philadelphia, PA., Umyarova E; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH.; Department of Medicine, University of Vermont, Burlington, VT., Annunzio K; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH., Sawalha Y; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH., Christian B; Division of Hematology, Department of Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH., Thomas C; Department of Medicine, Thomas Jefferson University, Philadelphia, PA., Barta SK; Department of Medicine, University of Pennsylvania, Philadelphia, PA., Geethakumari PR; Department of Medicine, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX., Bartlett NL; Department of Medicine, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO., Grover NS; Department of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC., Olszewski AJ; Department of Medicine, Brown University, Providence, RI.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Sep 12; Vol. 7 (17), pp. 5038-5046.
DOI:	10.1182/bloodadvances.2023010133
Abstrakt:	Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (hazard ratio, 1.74; 95% confidence interval, 1.20-2.54; P = .004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS based on the first-line therapy in patients with M-protein at diagnosis, in that, those receiving immunochemotherapy had better outcomes compared with those receiving rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein; however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further. (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu