Publication details

Multicentered patient-based evidence of the role of free light chain ratio normalization in multiple myeloma disease relapse

Authors

RADOCHA Jakub POUR Luděk PIKA Tomáš MAISNAR Vladimír ŠPIČKA Ivan GREGORA Evžen KREJČÍ Marta MINAŘÍK Jiří MACHÁLKOVÁ Kateřina STRAUB Jan PAVLÍČEK Petr HÁJEK Roman ŽÁK Pavel

Year of publication 2016
Type Article in Periodical
Magazine / Source European Journal of Haematology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1111/ejh.12556
Field Oncology and hematology
Keywords multiple myeloma; free light chains; complete remission; overall survival; time to progression
Description Introduction: The normalization of free light chain ratio (FLCr) has been introduced as a marker of stringent complete remission (CR) of multiple myeloma (MM). There is currently a lack of literature assessing the role of FLCr on MM disease progression and remission status. Patients and methods: A multicentered retrospective review of 125 patients with MM in CR and various FLCr values was completed. Parameters of interest included patient demographics, FLCr values, complete remission (CR)/relapse status, and time to progression (TTP). The FLCr values were recorded to provide time-dependent findings on the role of FLCr on progression-free survival and overall survival (OS). Results: The mean follow-up time of 125 patients from five hospitals in the Czech Republic was 31 months. A total of 47.2% of patients relapsed (54 of 125) during the follow-up period. The median TTP of patients with normal FLCr (n = 66) was 54.4 and 40.2 months for patients with abnormal FLCr (n = 59) (P = 0.217). None of the patients reached median overall survival regardless of FLCr values (P = 0.821). In the subgroup of newly diagnosed patients after upfront autologous stem cell transplantation (ASCT), there were 55.6% of patients (35 of 63) with normal FLCr and 44.4% (28 of 64) with abnormal FLCr. A total of 34.9% of patients (22 of 63) relapsed in this subgroup. Within the abnormal FLCr patients, a median TTP was 56.3 months, but no median TTP was reached among the normal FLCr patients (P = 0.746). Median OS in patients with normal (nFLCr) and abnormal FLCr (aFLCr) was not reached (P = 0.787). Conclusion: We did not observe any benefit from FLCr normalization in CR in myeloma patients in terms of progression-free survival or overall survival.

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