Sustained Suppression of Involved Free Light Chain Predicts Long Term Outcomes in Multiple Myeloma after Allogeneic Hematopoietic Stem Cell Transplantation: A Multi-Institutional Study

Cornell, Robert F.; Dogra, Shibani; Brazauskas, Ruta; Goodman, Stacey; Jagasia, Madan; Kassim, Adetola A.; McDonagh, Kevin T.; Savani, Bipin N.; Hari, Parameswaran

doi:10.1016/j.bbmt.2013.12.089

Cited by 2 publications

(4 citation statements)

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“…If at diagnosis, sFLC ratio is a predictor of more aggressive disease (Kyrtsonis et al, 2007;Van Rhee et al, 2007), regarding correlations of this value with response values, the consensus was not unanimous, as normal sFLC did not necessarily correlate with MRDnegativity (Giarin et al, 2009;Kapoor et al, 2013;Mead & Drayson, 2009;Singhal et al, 2009;Martinez-Lopez et al, 2015). Similar results emerged, in 2013 and 2014, from studies by Smeltzer et al (2013), andCornell et al (2014), using involved FLC at 1 year after ASCT in samples of 697 and 50 patients respectively. In 2007, an American group reported the results of a tight monitoring of sFLC levels, carrying out surveys at onset, no later than 7 days at the beginning of the first induction cycle, before the second one, and then before the first ASCT, demonstrating that higher tumour In 2011, a Spanish group, demonstrating high rate of discrepancy in terms of PFS and TTP, simultaneously compared results of immunofixation, sFLC, and MFC of 102 patients who achieved partial response with ≥70% reduction in M-component, out of a total of 260 (Paiva, Martinez-Lopez, et al, 2011;Paiva, Perez-Andres, et al, 2011).…”

Section: Serological Response Evaluation By Sflcsupporting

confidence: 61%

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Standardisation of minimal residual disease in multiple myeloma

et al. 2017

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The assessment of the effectiveness of chemotherapy in oncology cannot disregard the concept of minimal residual disease (MRD). In fact, the efforts of numerous scientific groups all over the world are currently focusing on this issue, with the sole purpose of defining sensitive, effective assessment criteria that are, above all, able to give acceptable, easily repeatable results worldwide. Regarding this issue, especially with the advent of new drugs, multiple myeloma is one of the haematologic malignancies for which a consensus has not yet been reached. In this review, we analyse various techniques that have been used to improve the sensitivity of response, aimed at reducing the cut-off values previously allowed, as well as serological values like serum-free light chain, or immunophenotypic tools on bone marrow or peripheral blood, like multi-parameter flow cytometry, or molecular ones such as allele-specific oligonucleotide (ASO)-qPCR and next-generation/high-throughput sequencing technologies (NGS). Moreover, our discussion makes a brief reference to promising techniques, such as mass spectrometry for identifying Ig light chain (LC) in peripheral blood, and the assessment of gene expression profile not only in defining prognostic risk at the diagnosis but also as a tool for evaluation of response.

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Section: Serological Response Evaluation By Sflcsupporting

confidence: 61%

“…Similar results emerged, in 2013 and 2014, from studies by Smeltzer et al (2013), andCornell et al (2014), using involved FLC at 1 year after ASCT in samples of 697 and 50 patients respectively.…”

Section: Serological Response Evaluation By Sflcsupporting

confidence: 61%

Standardisation of minimal residual disease in multiple myeloma

et al. 2017

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“…These observed improvements in clinical outcomes were independent of CR attainment. 17 Cornell et al 18 reported similar findings when they evaluated FLC in 50 patients following allogeneic stem cell transplantation. Patients with sustained iFLC suppression had improved OS compared with those that lacked evidence of iFLC suppression at 1-year post allogeneic stem cell transplantation (P = 0.03).…”

Section: Novel Biochemical Techniques For Serological Monitoring Of MMmentioning

confidence: 69%

“…Patients with iFLC recovery before 1 year had increased relapse risk compared with those patients that exhibited sustained iFLC suppression (HR: 10.4, 95% CI: 2.95-36.6, P o 0.001). 18 FLC assay has limited utility in the setting of renal insufficiency. The κ-light chains are produced at double the rate of the λ-light chain.…”

Section: Novel Biochemical Techniques For Serological Monitoring Of MMmentioning

confidence: 99%