Avivi I, Cohen YC, Joffe E, Benyamini N, Held-Kuznetsov V, Trestman S, et al. Serum free immunoglobulin light chain fingerprint identifies a subset of newly diagnosed multiple myeloma patients with worse outcome. Hematol Oncol 2016.
FLC were assessed in 255 newly diagnosed MM patients treated with Bortezomib induction to determine whether significantly elevated iFLC levels offers prognostic significance.
Patients were categorised based on their iFLC and M-protein levels, using cutoffs based on median values.
- HiLC (high iFLC levels only, >700 mg/L),
- HiMP (high M-protein levels only, >25 g/L)
- HiLC-MP (both high iFLC and M-protein levels),
- LoLC-MP (both iFLC and M-protein levels low, iFLC <700 mg/L and M-protein <25 g/L)
The HiLC group included 68 (27%) patients, and were significantly older (p=0.041) and more likely to present with renal impairment (p<0.0001) and ISS stage 3 (p<0.0001) than for any other category.
- Older patients were less likely to receive a transplant.
When non-transplanted and transplanted patients were analysed separately, the HiLC phenotype was significantly associated with shorter PFS and OS in non-transplanted patients (p=0.05 and p=0.04 respectively) but not in transplanted patients (p=0.25 and p=0.28 respectively).
The authors conclude that they ‘identified an LC predominant fingerprint at diagnosis as potential risk factor that may be associated with adverse outcome in [newly diagnosed] MM patients treated with bortezomib-based induction therapy.’