Bortezomib based therapies and High Cut Off filter dyalysis (HCO) are effective in Multiple Myeloma patients with end stage renal failure

Autor: Alessandro Gozzetti, Veronica Candi, F. Bacchiarri, C. Zuanelli Brambilla, Giulia Papini, Monica Bocchia, Alberto Bosi, Chiara Nozzoli
Rok vydání: 2015
Předmět:
Zdroj: Clinical Lymphoma Myeloma and Leukemia. 15:e135
ISSN: 2152-2650
DOI: 10.1016/j.clml.2015.07.332
Popis: 6.02 (5.35-17.45); 3 IgG : 0.45 (0.15-1.07)) and 3 IgA (2.51 (1.994.94) which was not detected by IFE. In 9/9 patients the abnormal HLC ratio was seen in concordance with the clonality identified by FLC and in 7/9 patients the ratio was abnormal due to suppression rather than M protein production. Reductions in the dHLC or normalisation of the HLC ratio were concordant with both FLC assessment and clinical response in 4 patients (PR, VGPR and 2 CR). In the discordant patients, 4/5 achieved less than CR; in these patients the HLC ratio normalised but the uninvolved isotypematched immunoglobulin (uHLC) remained suppressed. For the remaining 1/5 discordant patient FLC levels normalised but the ratio stayed outside the normal range, consistent with CR; in this patient the HLC ratio was abnormal throughout due to stable but persistent suppression of the uninvolved HLC. Overall uHLC levels remained suppressed in all patients achieving less than CR, but only in 1/3 of those at CR. Conclusion: By using the HLC assay we were able to identify monoclonal immunoglobulin producing subclones in patients with light chain myeloma which were not detected by conventional techniques. In addition we found recovery of the uninvolved HLC correlated with depth of response in the majority of patients.
Databáze: OpenAIRE
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