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23-10-2024 | Multiple Myeloma | Research

Immunoparesis recovery in newly diagnosed transplant ineligible multiple myeloma patients, an independent prognostic factor that complements minimal residual disease

Authors: Sunil Lakhwani, María Victoria Mateos, Joaquín Martínez-López, Bruno Paiva, Laura Rosiñol Dachs, Rafael Martínez, Albert Oriol, Joan Bargay, Yolanda González-Montes, Mercedes Gironella, Cristina Encinas, Jesús Martín, Isidro Jarque, Miquel Granell, Eugenia Abella, Aránzazu García-Mateo, José Ángel Hernández-Rivas, Elena Ramila, Isabel Krsnik, Luis Felipe Casado Montero, Felipe De Arriba, Luis Palomera, Antonia Sampol, José María Moraleda, María Casanova, Pilar Delgado, Ana Lafuente, Elena Amutio, Aurelio López-Martínez, Albert Altés, M. Ángeles Ruíz, Adrián Alegre, Lucia Lopez-Anglada, Javier De La Cruz, Rafael Alonso Fernández, Joan Bladé Creixenti, Juan-José Lahuerta, Jesús San-Miguel, Miguel-Teodoro Hernández

Published in: Annals of Hematology

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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.
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Metadata
Title
Immunoparesis recovery in newly diagnosed transplant ineligible multiple myeloma patients, an independent prognostic factor that complements minimal residual disease
Authors
Sunil Lakhwani
María Victoria Mateos
Joaquín Martínez-López
Bruno Paiva
Laura Rosiñol Dachs
Rafael Martínez
Albert Oriol
Joan Bargay
Yolanda González-Montes
Mercedes Gironella
Cristina Encinas
Jesús Martín
Isidro Jarque
Miquel Granell
Eugenia Abella
Aránzazu García-Mateo
José Ángel Hernández-Rivas
Elena Ramila
Isabel Krsnik
Luis Felipe Casado Montero
Felipe De Arriba
Luis Palomera
Antonia Sampol
José María Moraleda
María Casanova
Pilar Delgado
Ana Lafuente
Elena Amutio
Aurelio López-Martínez
Albert Altés
M. Ángeles Ruíz
Adrián Alegre
Lucia Lopez-Anglada
Javier De La Cruz
Rafael Alonso Fernández
Joan Bladé Creixenti
Juan-José Lahuerta
Jesús San-Miguel
Miguel-Teodoro Hernández
Publication date
23-10-2024
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-024-06031-0

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