title: Abnormal heavy/light chain ratio after treatment is associated with shorter survival in patients with IgA myeloma.
abstract: Immunoglobulin (Ig) heavy/light chain (HLC) assays enable the separate quantification of the different light chain types of each Ig class. We retrospectively analyzed the correlation of heavy/light chain ratio (HLCR) with clinical status and its impact on outcome in 120 patients with multiple myeloma (MM). Abnormal HLCR was seen more frequently in patients with poorer myeloma response, and it appeared to be more sensitive for detecting clonality in IgA myeloma compared to IgG myeloma after treatment. Among the 85 patients who achieved ≥VGPR, the patients remained HLCR abnormal were showed significantly shorter overall survival (OS) compared to those achieving a normal HLCR (not reached vs 55.5 months, P = 0.032). This correlation was seen in IgA myeloma patients (not reached vs 30.1 months, P = 0.014), but not in IgG myeloma patients when patients were analyzed separately. Univariate and multivariate analysis of factors that may affect survival identified abnormal HLCR at the best response as the only independent risk factor (hazard ratio, 4.7; 95% confidence interval, 1.4 - 15.26; P = 0.012) for shorter OS in this subset of patients. This study highlighted the HLC assay as a prognostic predictor in patients with IgA myeloma.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Suehara
authors.affiliation: Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamatsu
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Narita
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Usui
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: The Binding Site Ltd., Birmingham, UK.
authors.forename: Kelly
authors.initials: K
authors.lastname: Endean
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Chiba, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood; D007143:Immunoglobulin Heavy Chains / Q000097:blood*; D007147:Immunoglobulin Light Chains / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000401:mortality*; D012189:Retrospective Studies
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007143:Immunoglobulin Heavy Chains; D007147:Immunoglobulin Light Chains
keywords: Best response; IgA myeloma; IgG myeloma; heavy/light chain assay; survival