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| Título: | Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials |
Autor: | López-Anglada, Lucía; Cueto-Felgueroso, Cecilia; Rosiñol, Laura; Oriol, Albert; Teruel, Ana-Isabel; López de la Guía, Ana; Bengoechea, Enrique; Palomera, Luis; Arriba, Felipe de; Hernandez, Jose Mariano; Granell, Miquel; Peñalver, Francisco-Javier; García-Sanz, Ramón | Fecha de publicación: | 7-sep-2018 | Editor: | Public Library of Science | Citación: | PLoS ONE 13(9): e0203392 (2018) | Resumen: | We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (<0.03 or >32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (<0.29 or >73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment. | Descripción: | © 2018 Lopez-Anglada et al. | Versión del editor: | http://dx.doi.org/10.1371/journal.pone.0203392 | URI: | http://hdl.handle.net/10261/245170 | DOI: | 10.1371/journal.pone.0203392 | E-ISSN: | 1932-6203 |
| Aparece en las colecciones: | (IBMCC) Artículos |
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| Prognostic_Lopez_pV_Art2018.pdf | 1,72 MB | Adobe PDF |  Visualizar/Abrir |
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