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Leukemia. 2014 Oct;28(10):2075-9. doi: 10.1038/leu.2014.110. Epub 2014 Mar 18.

Preserved levels of uninvolved immunoglobulins are independently associated with favorable outcome in patients with symptomatic multiple myeloma.

Author information

1
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
2
Hematology Division, Department of Internal Medicine, University of Patras Medical School, Patras, Greece.
3
Department of Hematology, St Savvas Oncology Hospital, Athens, Greece.
4
Department of Hematology and Bone Marrow Transplantation Unit, Evangelismos Hospital, Athens, Greece.
5
Department of Hematology, Theagenio Cancer Hospital, Thessaloniki, Greece.
6
Department of Hematology, 'Georgios Gennimatas' General Hospital, Athens, Greece.
7
Department of Hematology, Nicosia General Hospital, Nicosia, Cyprus.
8
Department of Hematology, University Hospital of Ioannina, Ioannina, Greece.
9
Department of Hematology, Metaxa Cancer Hospital, Piraeus, Greece.
10
Department of Hematology, Democritus University of Thrace Medical School, Alexandroupolis, Greece.
11
Department of Hematology, General Hospital of Chalkida, Chalkida, Greece.
12
Department of Hematology, Amalia Fleming General Hospital, Athens, Greece.
13
Second Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
14
Hematology Section and Laboratory, First Department of Propaedeutic Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
15
First Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
16
Immunology Labaratory, 'Alexandra' Hospital, Athens, Greece.

Abstract

Suppression of uninvolved immunoglobulins is common in multiple myeloma (MM) but the prognostic significance of this phenomenon has not been assessed. We evaluated the prognostic significance of the preservation of uninvolved immunoglobulins in 1755 consecutive, unselected, patients with newly diagnosed, symptomatic MM with pre-therapy immunoglobulin levels measured by nephelometry. Suppression of at least one uninvolved immunoglobulin was observed in 87% of patients and was more common in patients with immunoglobulin A myeloma, those aged over 65 years, in patients with advanced-International Staging System (ISS) stage, extensive-bone marrow infiltration, anemia, low platelet counts, high levels of serum M-monoclonal protein or renal dysfunction. Patients with preserved immunoglobulins had a better survival than patients with suppressed immunoglobulins (median survival 55 vs 41.5 months, P<0.001). In multivariate analysis, preservation of uninvolved immunoglobulins was independently associated with better survival (hazard ratio: 0.781, 95% confidence interval: 0.618-0.987, P=0.039); irrespective of the treatment. In a subset of 500 patients, which were strictly followed for disease progression, preservation of uninvolved immunoglobulins was associated with a significantly longer progression-free survival (60 vs 25 months, P<0.001), independently of other common prognostic factors. In conclusion, preservation of uninvolved immunoglobulins in newly diagnosed patients with symptomatic MM was independently associated with long term disease control and improved survival.

PMID:
24637336
DOI:
10.1038/leu.2014.110
[Indexed for MEDLINE]

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