Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection

Immunoparesis (IP) in multiple myeloma (MM) patients can be measured by classic assessment of immunoglobulin (Ig) levels or by analysis of the uninvolved heavy/light chain pair of the same immunoglobulin (uHLC) by the Hevylite (R) assay. In this study we evaluate the prognostic value of recovery fro...

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Autores: Lakhwani, Sunil, Rosiñol Dachs, Laura, Puig, Noemí, Pico Picos, Miguel Ángel, Medina González, Laura, Martínez López, Joaquín, Paiva, Bruno, Cedena, María Teresa, Oriol, Albert, Ríos Tamayo, Rafael, Blanchard, María Jesús, Jarque, Isidro, Bargay, Joan, Moraleda, José María, Carrillo Cruz, Estrella, Sureda, Anna, Krsnik, Isabel, González, Esther, Casado, Luis Felipe, Martí, Josep M, Encinas, Cristina, Arriba, Felipe de, Palomera, Luis, Sampol, Antonia, González Montes, Yolanda, Motlló, Cristina, Cruz, Javier de la, Alonso, Rafael, Mateos, María Victoria, Bladé, J. (Joan), Lahuerta, Juan José, San Miguel, Jesús, Hernández, Miguel Teodoro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/215290
Acceso en línea:https://hdl.handle.net/2445/215290
Access Level:acceso abierto
Palabra clave:Mieloma múltiple
Trasplantament d'òrgans
Multiple myeloma
Transplantation of organs
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spelling Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detectionLakhwani, SunilRosiñol Dachs, LauraPuig, NoemíPico Picos, Miguel ÁngelMedina González, LauraMartínez López, JoaquínPaiva, BrunoCedena, María TeresaOriol, AlbertRíos Tamayo, RafaelBlanchard, María JesúsJarque, IsidroBargay, JoanMoraleda, José MaríaCarrillo Cruz, EstrellaSureda, AnnaKrsnik, IsabelGonzález, EstherCasado, Luis FelipeMartí, Josep MEncinas, CristinaArriba, Felipe dePalomera, LuisSampol, AntoniaGonzález Montes, YolandaMotlló, CristinaCruz, Javier de laAlonso, RafaelMateos, María VictoriaBladé, J. (Joan)Lahuerta, Juan JoséSan Miguel, JesúsHernández, Miguel TeodoroMieloma múltipleTrasplantament d'òrgansMultiple myelomaTransplantation of organsImmunoparesis (IP) in multiple myeloma (MM) patients can be measured by classic assessment of immunoglobulin (Ig) levels or by analysis of the uninvolved heavy/light chain pair of the same immunoglobulin (uHLC) by the Hevylite (R) assay. In this study we evaluate the prognostic value of recovery from IP measured by classic total Ig and uHLC assessment in newly diagnosed MM transplant -eligible (NDMM-TE) patients with intensive treatment and its association with minimal residual disease (MRD). Patients were enrolled and treated in the PETHEMA/GEM2012MENOS65 trial and continued in the PETHEMA /GEM2014MAIN trial. Total Ig (IgG, IgA and IgM) and uHLC were analyzed in a central laboratory at diagnosis, after consolidation treatment and after the first year of maintenance. MRD was analyzed by next -generation flow cytometry after consolidation (sensitivity level 2x10 (-6 )). We found no differences in progression -free survival (PFS) between patients who recovered and patients who didn't recover from IP after consolidation when examining classic total Ig and uHLC. However, after the first year of maintenance, in contrast to patients with classic IP, patients with recovery from uHLC IP had longer PFS than patients without recovery, with hazard ratio of 0.42 (95% confidence interval [CI]: 0.21-0.81; P =0.008). Multivariate analysis with Cox proportional -hazards re - gression models confirmed recovery from uHLC IP after the first year of maintenance as an independent prognostic factor for PFS, with an increase in C -statistic of 0.05 (95% CI: -0.04 to 0.14; P <0.001) when adding uHLC IP recovery. Moreover, we observed that MRD status and uHLC IP recovery affords complementary information for risk stratification. In conclusion, recov - ery from uHLC IP after 1 year of maintenance is an independent prognostic factor for PFS in NDMM-TE patients who receive intensive treatment. Immune reconstitution, measured as recovery from uHLC IP, provides complementary prognostic information to MRD assessment ( clinicaltrials gov. Identifiers: NCT01916252 and NCT02406144 ).Ferrata Storti Foundation (Haematologica)2024202420232024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion9 p.application/pdfhttps://hdl.handle.net/2445/215290Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3324/haematol.2023.284154Haematologica, 2023https://doi.org/10.3324/haematol.2023.284154cc by-nc (c) Lakhwani, Sunil et al, 2023http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2152902026-05-29T05:05:01Z
dc.title.none.fl_str_mv Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
title Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
spellingShingle Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
Lakhwani, Sunil
Mieloma múltiple
Trasplantament d'òrgans
Multiple myeloma
Transplantation of organs
title_short Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
title_full Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
title_fullStr Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
title_full_unstemmed Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
title_sort Recovery of uninvolved heavy/light chain pair immunoparesis in newly diagnosed transplant-eligible myeloma patients complements the prognostic value of minimal residual disease detection
dc.creator.none.fl_str_mv Lakhwani, Sunil
Rosiñol Dachs, Laura
Puig, Noemí
Pico Picos, Miguel Ángel
Medina González, Laura
Martínez López, Joaquín
Paiva, Bruno
Cedena, María Teresa
Oriol, Albert
Ríos Tamayo, Rafael
Blanchard, María Jesús
Jarque, Isidro
Bargay, Joan
Moraleda, José María
Carrillo Cruz, Estrella
Sureda, Anna
Krsnik, Isabel
González, Esther
Casado, Luis Felipe
Martí, Josep M
Encinas, Cristina
Arriba, Felipe de
Palomera, Luis
Sampol, Antonia
González Montes, Yolanda
Motlló, Cristina
Cruz, Javier de la
Alonso, Rafael
Mateos, María Victoria
Bladé, J. (Joan)
Lahuerta, Juan José
San Miguel, Jesús
Hernández, Miguel Teodoro
author Lakhwani, Sunil
author_facet Lakhwani, Sunil
Rosiñol Dachs, Laura
Puig, Noemí
Pico Picos, Miguel Ángel
Medina González, Laura
Martínez López, Joaquín
Paiva, Bruno
Cedena, María Teresa
Oriol, Albert
Ríos Tamayo, Rafael
Blanchard, María Jesús
Jarque, Isidro
Bargay, Joan
Moraleda, José María
Carrillo Cruz, Estrella
Sureda, Anna
Krsnik, Isabel
González, Esther
Casado, Luis Felipe
Martí, Josep M
Encinas, Cristina
Arriba, Felipe de
Palomera, Luis
Sampol, Antonia
González Montes, Yolanda
Motlló, Cristina
Cruz, Javier de la
Alonso, Rafael
Mateos, María Victoria
Bladé, J. (Joan)
Lahuerta, Juan José
San Miguel, Jesús
Hernández, Miguel Teodoro
author_role author
author2 Rosiñol Dachs, Laura
Puig, Noemí
Pico Picos, Miguel Ángel
Medina González, Laura
Martínez López, Joaquín
Paiva, Bruno
Cedena, María Teresa
Oriol, Albert
Ríos Tamayo, Rafael
Blanchard, María Jesús
Jarque, Isidro
Bargay, Joan
Moraleda, José María
Carrillo Cruz, Estrella
Sureda, Anna
Krsnik, Isabel
González, Esther
Casado, Luis Felipe
Martí, Josep M
Encinas, Cristina
Arriba, Felipe de
Palomera, Luis
Sampol, Antonia
González Montes, Yolanda
Motlló, Cristina
Cruz, Javier de la
Alonso, Rafael
Mateos, María Victoria
Bladé, J. (Joan)
Lahuerta, Juan José
San Miguel, Jesús
Hernández, Miguel Teodoro
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Mieloma múltiple
Trasplantament d'òrgans
Multiple myeloma
Transplantation of organs
topic Mieloma múltiple
Trasplantament d'òrgans
Multiple myeloma
Transplantation of organs
description Immunoparesis (IP) in multiple myeloma (MM) patients can be measured by classic assessment of immunoglobulin (Ig) levels or by analysis of the uninvolved heavy/light chain pair of the same immunoglobulin (uHLC) by the Hevylite (R) assay. In this study we evaluate the prognostic value of recovery from IP measured by classic total Ig and uHLC assessment in newly diagnosed MM transplant -eligible (NDMM-TE) patients with intensive treatment and its association with minimal residual disease (MRD). Patients were enrolled and treated in the PETHEMA/GEM2012MENOS65 trial and continued in the PETHEMA /GEM2014MAIN trial. Total Ig (IgG, IgA and IgM) and uHLC were analyzed in a central laboratory at diagnosis, after consolidation treatment and after the first year of maintenance. MRD was analyzed by next -generation flow cytometry after consolidation (sensitivity level 2x10 (-6 )). We found no differences in progression -free survival (PFS) between patients who recovered and patients who didn't recover from IP after consolidation when examining classic total Ig and uHLC. However, after the first year of maintenance, in contrast to patients with classic IP, patients with recovery from uHLC IP had longer PFS than patients without recovery, with hazard ratio of 0.42 (95% confidence interval [CI]: 0.21-0.81; P =0.008). Multivariate analysis with Cox proportional -hazards re - gression models confirmed recovery from uHLC IP after the first year of maintenance as an independent prognostic factor for PFS, with an increase in C -statistic of 0.05 (95% CI: -0.04 to 0.14; P <0.001) when adding uHLC IP recovery. Moreover, we observed that MRD status and uHLC IP recovery affords complementary information for risk stratification. In conclusion, recov - ery from uHLC IP after 1 year of maintenance is an independent prognostic factor for PFS in NDMM-TE patients who receive intensive treatment. Immune reconstitution, measured as recovery from uHLC IP, provides complementary prognostic information to MRD assessment ( clinicaltrials gov. Identifiers: NCT01916252 and NCT02406144 ).
publishDate 2023
dc.date.none.fl_str_mv 2023
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/215290
url https://hdl.handle.net/2445/215290
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3324/haematol.2023.284154
Haematologica, 2023
https://doi.org/10.3324/haematol.2023.284154
dc.rights.none.fl_str_mv cc by-nc (c) Lakhwani, Sunil et al, 2023
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Lakhwani, Sunil et al, 2023
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 9 p.
application/pdf
dc.publisher.none.fl_str_mv Ferrata Storti Foundation (Haematologica)
publisher.none.fl_str_mv Ferrata Storti Foundation (Haematologica)
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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