Mass spectrometry vs immunofixation for treatment monitoring in multiple myeloma

Monitoring of the monoclonal protein (M-protein) by electrophoresis and/or immunofixation (IFE) has long been used to assess treatment response in multiple myeloma (MM). However, with the use of highly effective therapies, the M-protein becomes frequently undetectable, and more sensitive methods had...

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Detalles Bibliográficos
Autores: Puig, Noemí, Contreras, María Teresa, Agulló, Cristina, Martínez-López, Joaquín, Oriol, Albert, Blanchard, María-Jesús, Rios, Rafael, Martín, Jesús, Iñigo, María-Belén, Sureda, Anna, Hernández, Miguel-Teodoro, de la Rubia Comos, Javier, González-Calle, Verónica, Krsnik, Isabel, Cabañas Perianes, Valentin, Palomera, Luis, Moraleda, José-María, Bargay Lleonart, Joan, Cedena, Maria Teresa, Paiva, Bruno, Rosiñol, Laura, Bladé, Joan, San Miguel, Jesus F., Lahuerta, Juan-José, Mateos, Maria-Victoria
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/18214
Acceso en línea:https://hdl.handle.net/20.500.13003/18214
Access Level:acceso abierto
Palabra clave:Multiple Myeloma
Hematopoietic Stem Cell Transplantation
Antibodies, Monoclonal
Transplantation, Autologous
Humans
Immunoglobulin Light Chains
Mass Spectrometry
Cadenas Ligeras de Inmunoglobulina
Espectrometría de Masas
Trasplante de Células Madre Hematopoyéticas
Humanos
Mieloma Múltiple
Trasplante Autólogo
Anticuerpos Monoclonales
Descripción
Sumario:Monitoring of the monoclonal protein (M-protein) by electrophoresis and/or immunofixation (IFE) has long been used to assess treatment response in multiple myeloma (MM). However, with the use of highly effective therapies, the M-protein becomes frequently undetectable, and more sensitive methods had to be explored. We applied IFE and mass spectrometry (EXENT&FLC-MS) in serum samples from newly diagnosed MM patients enrolled in the PETHEMA/GEM2012MENOS65 obtained at baseline (n = 223), and after induction (n = 183), autologous stem cell transplantation (n = 173), and consolidation (n = 173). At baseline, the isotypes identified with both methods fully matched in 82.1% of samples; in the rest but 2 cases, EXENT&FLC-MS provided additional information to IFE with regards to the M-protein(s). Overall, the results of EXENT&FLC-MS and IFE were concordant in >80% of cases, being most discordances due to EXENT&FLC-MS+ but IFE- cases. After consolidation, IFE was not able to discriminate 2 cohorts with different median progression-free survival (PFS), but EXENT&FLC-MS did so; furthermore, among IFE- patients, EXENT&FLC-MS identified 2 groups with significantly different median PFS (P = .0008). In conclusion, compared with IFE, EXENT&FLC-MS is more sensitive to detect the M-protein of patients with MM, both at baseline and during treatment, and provides a more accurate prediction of patients' outcome. This trial was registered at www.clinicaltrials.gov as #NCT01916252.

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