For survival, the emergence of oligoclonal bands after multiple myeloma treatment is less important than achieving complete remission

Abstract

BackgroundThe emergence of oligoclonal bands, proteins differing from those originally identified at diagnosis, has been reported in multiple myeloma patients after high-dose chemotherapy followed by autologous stem cell transplantation and after successful conventional chemotherapy. The clinical relevance of oligoclonal bands remains unclear, but their emergence has been associated with better prognosis. The aim of the present study was to determine the prevalence, clinical characteristics and prognostic impact of the presence of oligoclonal bands in multiple myeloma patients.MethodsA retrospective cohort study was conducted. The study included newly diagnosed multiple myeloma patients with at least very good partial response after conventional dose or high-dose chemotherapy followed by autologous stem cell transplantation. The emergence of oligoclonal bands was identified using serum protein electrophoresis as well as serum and urine immunofixation techniques.ResultsA total of 101 patients were included with a median follow-up of 42 months. In total, 55% were male, and the median age was 58 years (29–87 years). Fifty-one (50.5%) patients developed oligoclonal bands. They comprised 60% (45/75) of patients treated with autologous stem cell transplantation and 23% (6/26) of those who were not transplanted. Patients with oligoclonal bands showed better progression-free survival than those without the emergence of oligoclonal bands (p-value = 0.0075).ConclusionThe prevalence of oligoclonal bands in this study population was 50.5% with its frequency being greater in cases treated with autologous stem cell transplantation and in those attaining complete remission. Complete remission was more important than the emergence of oligoclonal bands on progression-free survival.

Early M‐protein immune reconstitution after autologous haematopoietic stem cell transplantation is a good prognostic marker for patients with high‐risk cytogenetic multiple myeloma

“…In recent years, with the use of novel agents and haematopoietic stem cells in multiple myeloma, the incidence of M-P immune reconstitution after transplantation has increased substantially compared to conventional chemotherapy drugs, from single digits to 73%. 5,8,12,18,19 In 25.9% of patients, M-P immune reconstitution occurred at a median of 3 months post-ASCT. This incidence is similar to that previously reported.…”

“…This study confirms the incidence of M‐P immune reconstitution in patients with multiple myeloma after autologous haematopoietic stem cell transplantation. In recent years, with the use of novel agents and haematopoietic stem cells in multiple myeloma, the incidence of M‐P immune reconstitution after transplantation has increased substantially compared to conventional chemotherapy drugs, from single digits to 73% 5,8,12,18,19 . In 25.9% of patients, M‐P immune reconstitution occurred at a median of 3 months post‐ASCT.…”

An unusual pattern in serum protein electrophoresis to take in mind: A case report

“…In patients with multiple sclerosis or primary amyloidosis undergoing HSCT, an oligoclonal pattern can be observed in IFE after transplantation. Such finding is associated with a better outcome [ [12] , [13] , [14] ] and may appear sometimes as a two M - protein [ 14 ].…”