Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials
| Autor: | Lopez-Anglada, Lucia, Cueto-Felgueroso, Cecilia, Rosinol, Laura, Oriol, Albert, Isabel Teruel, Ana, Lopez de la Guia, Ana, Bengoechea, Enrique, Palomera, Luis, de Arriba, Felipe, Mariano Hernandez, Jose, Granell, Miquel, Javier Penalver, Francisco, Garcia-Sanz, Ramon, Besalduch, Juan, Gonzalez, Yolanda, Benigno Martinez, Rafael, Teodoro Hernandez, Miguel, Gutierrez, Norma C., Puerta, Paloma, Valeri, Antonio, Paiva, Bruno, Blade, Joan, Mateos, Maria-Victoria, San Miguel, Jesus, Jose Lahuerta, Juan, Martinez-Lopez, Joaquin, GEM Grp Espanol MM, PETHEMA Programa El Estudio |
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| Přispěvatelé: | Red Temática de Investigación Cooperativa en Cáncer (España), Instituto de Salud Carlos III, Ministerio de Industria y Competitividad (España), European Commission, Asociación Española Contra el Cáncer, Fundación CRIS contra el Cáncer |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Serum Proteins Physiology humanos Complement System lcsh:Medicine Phases of clinical research Drug research and development Kaplan-Meier Estimate Pathology and Laboratory Medicine Biochemistry Gastroenterology Plasma Cell Disorders cadenas ligeras de las inmunoglobulinas Hematologic Cancers and Related Disorders Binding Analysis Clinical trials 0302 clinical medicine Immune Physiology Antineoplastic Combined Chemotherapy Protocols Medicine and Health Sciences Medicine lcsh:Science Multiple myeloma Immune System Proteins Multidisciplinary medicine.diagnostic_test protocolos de quimioterapia antineoplásica combinada Hematology Induction Chemotherapy Prognosis Blood proteins Phase III clinical investigation pronóstico Myelomas Oncology 030220 oncology & carcinogenesis Serum protein electrophoresis Multiple Myeloma Immunoglobulin Heavy Chains Research Article estimación de Kaplan-Meier medicine.medical_specialty Immunology mieloma múltiple Immunoglobulin light chain Immune Suppression Transplantation Autologous Antibodies trasplante de células madre 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Internal medicine Humans Autologous transplantation Myelomas and Lymphoproliferative Diseases quimioterapia de inducción Chemical Characterization Retrospective Studies Pharmacology Transplantation business.industry lcsh:R estudios retrospectivos Cancers and Neoplasms Biology and Life Sciences Proteins Induction chemotherapy trasplante medicine.disease Research and analysis methods 030104 developmental biology Clinical Trials Phase III as Topic cadenas pesadas de las inmunoglobulinas Clinical medicine Immune System lcsh:Q Immunoglobulin Light Chains business Stem Cell Transplantation |
| Zdroj: | Digital.CSIC: Repositorio Institucional del CSIC Consejo Superior de Investigaciones Científicas (CSIC) PLoS One r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname BASE-Bielefeld Academic Search Engine Digital.CSIC. Repositorio Institucional del CSIC r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA PLoS ONE Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid Zaguán. Repositorio Digital de la Universidad de Zaragoza PLoS ONE, Vol 13, Iss 9, p e0203392 (2018) |
| ISSN: | 1932-6203 |
| Popis: | © 2018 Lopez-Anglada et al. We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment. This research project was supported by grants PI06339, PS09/01370, and PI12/01761 awarded to Sara Borrell (CD13/00340) and Juan Rodes (JR14/00016) from the Fondo de Investigación Sanitaria (FIS), the Red Temática de Investigación Cooperativa en Cáncer (RTICC) of the Instituto de Salud Carlos III (Ministry of Economy, Industry, and Competitiveness, Madrid, Spain), FEDER (RD12/0036/0061, RD12/0036/0048m and RD12/0036/0058) from FIS, the Asociación Española Contra el Cáncer (AECC; GCB120981SAN), and the CRIS Foundation. |
| Databáze: | OpenAIRE |
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