Scientific publications
Immunoparesis recovery in newly diagnosed transplant ineligible multiple myeloma patients, an independent prognostic factor that complements minimal residual disease. Scientific Publication
Sunil Lakhwani 1 , María Victoria Mateos 2 , Joaquín Martínez-López 3 , Bruno Paiva 4 , Laura Rosiñol Dachs 5 , Rafael Martínez 6 , Albert Oriol 7 , Joan Bargay 8 , Yolanda González-Montes 9 , Mercedes Gironella 10 , Cristina Encinas 11 , Jesús Martín 12 , Isidro Jarque 13 , Miquel Granell 14 , Eugenia Abella 15 , Aránzazu García-Mateo 16 , José Ángel Hernández-Rivas 17 , Elena Ramila 18 , Isabel Krsnik 19 , Luis Felipe Casado Montero 20 , Felipe De Arriba 21 , Luis Palomera 22 , Antonia Sampol 23 , José María Moraleda 24 , María Casanova 25 , Pilar Delgado 26 , Ana Lafuente 27 , Elena Amutio 28 , Aurelio López-Martínez 29 , Albert Altés 30 , M Ángeles Ruíz 31 , Adrián Alegre 32 , Lucia Lopez-Anglada 33 , Javier De La Cruz 34 , Rafael Alonso Fernández 3 , Joan Bladé Creixenti 5 , Juan-José Lahuerta # 34 , Jesús San-Miguel 4 , Miguel-Teodoro Hernández 35
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.
CITATION Ann Hematol. 2024 Oct 23. doi: 10.1007/s00277-024-06031-0
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