Implications of a Rising Serum Monoclonal Protein and Free Light Chains Post Autologous Stem Cell Transplant in Patients with Multiple Myeloma
Year: 2020
Type: article
Study design: Observational Study
Abstract: Background Patients(pts) who undergo autologous stem cell transplant (ASCT) for multiple myeloma (MM) are routinely assessed at Day-100 using serum monoclonal protein (M-spike), free light chains(FLC), and urine studies. Limited data are available to assess the prognostic value of an increasing M-spike or FLC from immediately before ASCT to Day-100 post-ASCT. We evaluated this in our cohort of patients. Methods We retrospectively reviewed 1070 pts with MM at Mayo Clinic, Rochester, who had their first ASCT between 2000 and 2016. We stratified pts according to a rise in M-spike by at least >0.1g/dl from immediately before ASCT to Day-100 post-ASCT (cohort 1) compared to those who did not (cohort 2). We also stratified pts according to a rise in involved FLC by at least >5mg/dl (cohort 3) compared to those who did not (cohort 4). Survival analysis for progression free survival (PFS) and overall survival (OS) was performed using the Kaplan Meier method. Results 46 pts were found to have a rise in M-spike by at least >0.1g/dl between pre-ASCT and Day-100 (cohort 1) and 825 pts were found to have a declining or 5mg/dl (cohort 3) and 1045 pts were found to have a decrease or a Conclusions An increase of M-spike by at least >0.1 g/dl and involved FLC by at least >5mg/dl from pre-ASCT to Day-100 is predictive of inferior PFS and OS in pts with MM. These patients would benefit from closer surveillance post Day-100.
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
OpenAlex ID: W3002948274