Changes in uninvolved immunoglobulins during induction therapy for newly diagnosed multiple myeloma

被引：7

作者：

Ravi, P. ^{[1
]}

Kumar, S. ^{[2
]}

Gonsalves, W. ^{[2
]}

Buadi, F. ^{[2
]}

Lacy, M. Q. ^{[2
]}

Go, R. S. ^{[2
]}

Dispenzieri, A. ^{[2
]}

Kapoor, P. ^{[2
]}

Lust, J. A. ^{[2
]}

Dingli, D. ^{[2
]}

Lin, Y. ^{[2
]}

Russell, S. J. ^{[2
]}

Leung, N. ^{[3
]}

Gertz, M. A. ^{[2
]}

Kyle, R. A. ^{[2
]}

Bergsagel, P. L. ^{[4
]}

Rajkumar, S. V. ^{[2
]}

机构：

[1] Mayo Clin, Dept Internal Med, Rochester, MN USA

[2] Mayo Clin, Div Hematol, 200 First St SW, Rochester, MN 55905 USA

[3] Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA

[4] Mayo Clin Arizona, Div Hematol & Oncol, Scottsdale, AZ USA

来源：

BLOOD CANCER JOURNAL | 2017年 / 7卷

关键词：

CELL MATURATION ANTIGEN; LENALIDOMIDE; PROGRESSION; RISK;

D O I：

10.1038/bcj.2017.46

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Little is known about the impact of multiple myeloma (MM) treatment on uninvolved immunoglobulins (Ig). We identified 448 patients who received high-dose dexamethasone (HD-DEX), lenalidomide and dexamethasone (RD), bortezomib and dexamethasone (VD), bortezomib, cyclophosphamide and dexamethasone (VCD) or bortezomib, lenalidomide and dexamethasone (VRD) for newly diagnosed MM at our institution between 2000 and 2013, and who had available data on absolute lymphocyte count (ALC) and quantitative uninvolved Ig at baseline and at the end of four cycles of therapy. Changes in ALC and uninvolved Ig were significantly different across treatments, with VCD and HD-DEX producing reductions in uninvolved Ig, and RD, VD and VRD leading to increases in uninvolved Ig. In addition, treatment with RD, VD and VRD was independently associated with higher odds of achieving a. 25% increase in or normalization of the primary uninvolved Ig on multivariate analysis. Although achievement of a humoral response in the primary uninvolved Ig was associated with a higher odds of achieving VGPR or better after four cycles of therapy, it was not associated with improved overall survival. These data highlight the different mechanisms of action of MM drugs and point toward a possible role for the use of VCD in treating antibody-mediated autoimmune disease.

引用

页码：e569 / e569

页数：6

共 21 条

[1]

[Anonymous], CLIN CANC RES

[2] Prognostic utility of intact immunoglobulin Ig′κ/Ig′λ ratios in multiple myeloma patients [J].

Bradwell, A. ;

Harding, S. ;

Fourrier, N. ;

Mathiot, C. ;

Attal, M. ;

Moreau, P. ;

Harousseau, J-L ;

Avet-Loiseau, H. .

LEUKEMIA, 2013, 27 (01) :202-207

[3] Efficacy and safety of long-term treatment with lenalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma [J].

Dimopoulos, M. A. ;

Swern, A. S. ;

Li, J. S. ;

Hussein, M. ;

Weiss, L. ;

Nagarwala, Y. ;

Baz, R. .

BLOOD CANCER JOURNAL, 2014, 4 :e257-e257

[4] International uniform response criteria for multiple myeloma [J].

Durie, B. G. M. ;

Harousseau, J-L ;

Miguel, J. S. ;

Blade, J. ;

Barlogie, B. ;

Anderson, K. ;

Gertz, M. ;

Dimopoulos, M. ;

Westin, J. ;

Sonneveld, P. ;

Ludwig, H. ;

Gahrton, G. ;

Beksac, M. ;

Crowley, J. ;

Belch, A. ;

Boccadaro, M. ;

Turesson, I. ;

Joshua, D. ;

Vesole, D. ;

Kyle, R. ;

Alexanian, R. ;

Tricot, G. ;

Attal, M. ;

Merlini, G. ;

Powles, R. ;

Richardson, P. ;

Shimizu, K. ;

Tosi, P. ;

Morgan, G. ;

Rajkumar, S. V. .

LEUKEMIA, 2006, 20 (09) :1467-1473

[5] Preserved levels of uninvolved immunoglobulins are independently associated with favorable outcome in patients with symptomatic multiple myeloma [J].

Kastritis, E. ;

Zagouri, F. ;

Symeonidis, A. ;

Roussou, M. ;

Sioni, A. ;

Pouli, A. ;

Delimpasi, S. ;

Katodritou, E. ;

Michalis, E. ;

Michael, M. ;

Hatzimichael, E. ;

Vassou, A. ;

Repousis, P. ;

Christophoridou, A. ;

Kartasis, Z. ;

Stefanoudaki, E. ;

Megalakaki, C. ;

Giannouli, S. ;

Kyrtsonis, M-C ;

Konstantopoulos, K. ;

Spyroupoulou-Vlachou, M. ;

Terpos, E. ;

Dimopoulos, M. A. .

LEUKEMIA, 2014, 28 (10) :2075-2079

[6] Suppression of uninvolved immunoglobulins defined by heavy/light chain pair suppression is a risk factor for progression of MGUS [J].

Katzmann, J. A. ;

Clark, R. ;

Kyle, R. A. ;

Larson, D. R. ;

Therneau, T. M. ;

Melton, L. J., III ;

Benson, J. T. ;

Colby, C. L. ;

Dispenzieri, A. ;

Landgren, O. ;

Kumar, S. ;

Bradwell, A. R. ;

Cerhan, J. R. ;

Rajkumar, S. V. .

LEUKEMIA, 2013, 27 (01) :208-212

[7] Review of 1027 patients with newly diagnosed multiple myeloma [J].

Kyle, RA ;

Gertz, MA ;

Witzig, TE ;

Lust, JA ;

Lacy, MQ ;

Dispenzieri, A ;

Fonseca, R ;

Rajkumar, SV ;

Offord, JR ;

Larson, DR ;

Plevak, ME ;

Therneau, TM ;

Greipp, PR .

MAYO CLINIC PROCEEDINGS, 2003, 78 (01) :21-33

[8] Targeting CD38 with Daratumumab Monotherapy in Multiple Myeloma [J].

Lokhorst, H. M. ;

Plesner, T. ;

Laubach, J. P. ;

Nahi, H. ;

Gimsing, P. ;

Hansson, M. ;

Minnema, M. C. ;

Lassen, U. ;

Krejcik, J. ;

Palumbo, A. ;

van de Donk, N. W. C. J. ;

Ahmadi, T. ;

Khan, I. ;

Uhlar, C. M. ;

Wang, J. ;

Sasser, A. K. ;

Losic, N. ;

Lisby, S. ;

Basse, L. ;

Brun, N. ;

Richardson, P. G. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (13) :1207-1219

[9] Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma [J].

Lonial, Sagar ;

Dimopoulos, Meletios ;

Palumbo, Antonio ;

White, Darrell ;

Grosicki, Sebastian ;

Spicka, Ivan ;

Walter-Croneck, Adam ;

Moreau, Philippe ;

Mateos, Maria-Victoria ;

Magen, Hila ;

Belch, Andrew ;

Reece, Donna ;

Beksac, Meral ;

Spencer, Andrew ;

Oakervee, Heather ;

Orlowski, Robert Z. ;

Taniwaki, Masafumi ;

Roellig, Christoph ;

Einsele, Hermann ;

Wu, Ka Lung ;

Singhal, Anil ;

San-Miguel, Jesus ;

Matsumoto, Morio ;

Katz, Jessica ;

Bleickardt, Eric ;

Poulart, Valerie ;

Anderson, Kenneth C. ;

Richardson, Paul .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (07) :621-631

[10] BLyS: Member of the tumor necrosis factor family and B lymphocyte stimulator [J].

Moore, PA ;

Belvedere, O ;

Orr, A ;

Pieri, K ;

LaFleur, DW ;

Feng, P ;

Soppet, D ;

Charters, M ;

Gentz, R ;

Parmelee, D ;

Li, YL ;

Galperina, O ;

Giri, J ;

Roschke, V ;

Nardelli, B ;

Carrell, J ;

Sosnovtseva, S ;

Greenfield, W ;

Ruben, SM ;

Olsen, HS ;

Fikes, J ;

Hilbert, DM .

SCIENCE, 1999, 285 (5425) :260-263

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