1. Immunoparesis recovery in newly diagnosed transplant ineligible multiple myeloma patients, an independent prognostic factor that complements minimal residual disease.
- Author
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Lakhwani S, Mateos MV, Martínez-López J, Paiva B, Rosiñol Dachs L, 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 JÁ, Ramila E, Krsnik I, Casado Montero LF, De Arriba F, Palomera L, Sampol A, Moraleda JM, Casanova M, Delgado P, Lafuente A, Amutio E, López-Martínez A, Altés A, Ruíz MÁ, Alegre A, Lopez-Anglada L, De La Cruz J, Alonso Fernández R, Bladé Creixenti J, Lahuerta JJ, San-Miguel J, and Hernández MT
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Prognosis, Lenalidomide administration & dosage, Lenalidomide therapeutic use, Prednisone administration & dosage, Prednisone therapeutic use, Retrospective Studies, Survival Rate, Aged, 80 and over, Multiple Myeloma mortality, Multiple Myeloma diagnosis, Neoplasm, Residual, Dexamethasone therapeutic use, Dexamethasone administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols administration & dosage
- Abstract
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., Competing Interests: Declarations. Ethical approval: The review board or independent ethics committee of each participating center approved the study. This trial was registered at www.clinicaltrials.gov with the number #NCT01237249. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
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