Immunoparesis recovery 1 year after ASCT is independently associated with favorable survival in patients with symptomatic multiple myeloma who undergo autologous stem cell transplantation
Immunoparesis is defined as a reduction in the levels of one, two, or three uninvolved immunoglobulins. However, there are very limited data on the incidence and prognostic significance of immunoparesis recovery 1 year after autologous stem cell transplantation (ASCT) in MM. We reviewed medical records of de novo MM patients who received ASCT at Beijing Chao Yang hospital. One hundred eight MM patients were included in the study. Conventional chemotherapy was administered as induction regimen in 16 patients (14.8%), whereas novel agents were used in 92 patients (85.2%). Most patients had immunoparesis at diagnosis (89.1%) and at the moment of ASCT as well (75%). After a median follow-up of 49 months, in the group with immunoglobulin recovery 1 year after ASCT, there was a trend towards longer progression-free survival (PFS) than in the group with immunoparesis (P = 0.054). And overall survival (OS) was significantly longer in patients with immunoparesis recovery (P = 0.004). In multivariate analysis, immunoparesis recovery 1 year after ASCT was independently associated with improved OS (P = 0.016). In conclusion, lack of immunoparesis recovery 1 year after ASCT in MM patients is associated with significantly shorter OS and this group of patients needs new treatment strategy to improve the prognosis.
KeywordsMultiple myeloma Immunoparesis Autologous stem cell transplantation
The authors would like to thank for these MM patients in the study. We thank for Dr. Lirong Liang for critically reviewing the manuscript.
W.G. collected and analyzed data and wrote the manuscript. J.L., G.Z.Y., Y.W., Y.C.L., Y.L., A.J.L., Y.T., H.J.W., G.R.W., T.H.H., Z.P.W., and Z.Y.R. contributed with treatment of patients and reviewed and approved the manuscript. W.M.C contributed with study design, data collection and interpretation, and manuscript writing.
This project was supported by grant and contract from basic and clinic research cooperation fund (grant 2015, 15JL37) and Students’ research innovation project (grant 2015, XSKY2015150) of Capital Medical University.
Compliance with ethical standards
Approval was obtained from the Institutional Review Board of Beijing Chao Yang Hospital for the analysis and publication of these data.
Conflict of interest
The authors declare that they have no conflict of interest.
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