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Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials.

Authors :
Lopez-Anglada L
Cueto-Felgueroso C
Rosiñol L
Oriol A
Teruel AI
Lopez de la Guia A
Bengoechea E
Palomera L
de Arriba F
Hernandez JM
Granell M
Peñalver FJ
Garcia-Sanz R
Besalduch J
Gonzalez Y
Martinez RB
Hernandez MT
Gutierrez NC
Puerta P
Valeri A
Paiva B
Blade J
Mateos MV
San Miguel J
Lahuerta JJ
Martinez-Lopez J
Source :
PloS one [PLoS One] 2018 Sep 07; Vol. 13 (9), pp. e0203392. Date of Electronic Publication: 2018 Sep 07 (Print Publication: 2018).
Publication Year :
2018

Abstract

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) (<0.03 or >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 (<0.29 or >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.<br />Competing Interests: The authors have declared that no competing interests exist.

Details

Language :
English
ISSN :
1932-6203
Volume :
13
Issue :
9
Database :
MEDLINE
Journal :
PloS one
Publication Type :
Academic Journal
Accession number :
30192814
Full Text :
https://doi.org/10.1371/journal.pone.0203392