Immunoparesis recovery in newly diagnosed transplant ineligible multiple myeloma patients, an independent prognostic factor that complements minimal residual disease

Information on the prognostic value of immunoparesis (IP) recovery in multiple myeloma (MM) patients has been only generated in some observational and retrospective studies. We have evaluated the prognostic impact of IP recovery and its association with minimal residual disease (MRD) in a series of...

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Detalles Bibliográficos
Autores: Lakhwani, S, Mateos, MV, Martinez-López, J, Paiva, B, Dachs, LR, Martínez, R, Oriol, A, Bargay, J, González-Montes, Y, Gironella, M, Encinas, C, Martín, J, Jarque, I, Granell, M, Abella, E, García-Mateo, A, Hernández-Rivas, JA, Ramila, E, Krsnik, I, Montero, LFC, De Arriba, F, Palomera, L, Sampol, A, Moraleda, JM, Casanova, M, Delgado, P, Lafuente, A, Amutio, E, López-Martínez, A, Altés, A, Ruíz, MA, Alegre, A, Lopez-Anglada, L, de la Cruz, J, Fernández, RA, Creixenti, JB, Lahuerta, JJ, San-Miguel, J, Hernández, MT
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p5315
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/5315
Access Level:acceso abierto
Palabra clave:Immunoparesis
Myeloma
Minimal residual disease
Immunoglobulin
Descripción
Sumario:Information on the prognostic value of immunoparesis (IP) recovery in multiple myeloma (MM) patients has been only generated in some observational and retrospective studies. We have evaluated the prognostic impact of IP recovery and its association with minimal residual disease (MRD) in a series of 113 newly diagnosed transplant-ineligible (NDTI) patients, that received fix duration treatment (18 cycles of VMP/lenalidomide-dexamethasone) within the PETHEMA/GEM2010MAS65 trial and who achieved CR or VGPR. Immunoglobulin levels were measured at diagnosis, at the end of treatment (after cycle 18th) and during subsequent follow up whereas MRD was analyzed only at the end of the treatment (after cycle 18th). We found that patients who had IP at diagnosis and recovered it during or after treatment had longer progression free survival (PFS) [p < 0.001; HR 0.32 (0.19-0.52)] and longer overall survival (OS) [p = 0.007; HR 0.40 (0.20-0.80)] compared to those who failed to recover it. When we analyzed IP recovery in MRD negative patients, we found that those cases with IP recovery had longer PFS [p = 0.007; HR 0.31 (0.13-0.76)] and longer OS [p = 0.012; HR 0.21 (0.06-0.80)] as compared to MRD negative patients but without IP recovery. In conclusion, IP recovery confers better prognosis in NDTI-MM patients with fixed duration treatment who achieve CR or VGPR and the prognostic value of MRD can be complemented when combined with IP recovery.

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