title: oligoclonal bands in patients with multiple myeloma: its emergence per se could not be translated to improved survival.
abstract: The emergence of oligoclonal bands (OB) has been reported in patients with multiple myeloma (MM) after stem cell transplantation (SCT) or successful chemotherapy. However, their clinical relevance remains unclear. We reviewed the clinical records of MM patients from January 2006 to May 2014. Treatment response was evaluated by International Working Group (IMWG) criteria. Serum immunofixation tests were performed at least every 3 months if the patient achieved more than very good partial response (VGPR). Free light chain (FLC) and minimal residual disease measurement by multicolor flow cytometry (MFC) were performed to evaluate the response to treatment. Among the 163 patients included in the study, 40 developed OB. Detection rates of OB in patients with complete response (CR), VGPR and partial response (PR) or less were 51.8, 36.3 and 0%, respectively. Patients with OB showed better progression-free survival (PFS) and overall survival (OS) rates than those without OB (P = 0.028 and P < 0.001, respectively). However, if the patients were limited to ≥VGPR or CR, development of OB did not affect PFS (P = 0.621 and P = 0.646, respectively) or OS (P = 0.189 and P = 0.766, respectively). OB was observed in 60% of patients after SCT, and in 36.6% of patients with more than VGPR without SCT (P < 0.001). Patients with OB tended to have less minimal residual disease than those without OB (P = 0.054) and its presence may affect the stringent CR criteria. In conclusion, the emergence of OB was seen exclusively in patients with favorable responses, but its emergence per se could not be translated to improved survival.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Kamogawa, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Seike
authors.forename: Kouta
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Suehara
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukaya
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugihara
authors.forename: Masami
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D043025:Oligoclonal Bands / Q000378:metabolism; D010950:Plasma Cells / Q000378:metabolism; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D043025:Oligoclonal Bands
keywords: Free light chain; Multiple myeloma; Oligoclonal band; minimal residual disease; stem cell transplantation